Premier Sean Chen has weighed in on the debate over international medical care, saying Taiwan should strengthen its domestic care before developing its international care.
"We have to take care of our own people first. We can take care of others after that," he said.
Along those lines, he urged the Department of Health (DOH) to address the staffing problems facing the five major branches of hospitals—internal medicine, external medicine, gynecology, pediatric care and emergency care—as soon as possible. Increases in medical litigation cases, threats of violence and overtime hours along with low compensation and other issues are conspiring to produce serious manpower shortages in these departments, leading observers to call them the "empty five."
The premier deems the problem extremely urgent and believes that an amendment to the Medical Care Act must be considered as a way to obtain a breakthrough. Meanwhile, though the second-generation National Health Insurance program has dealt with revenue problems, expenditures also merit attention because they direct care and drive the incentives of physicians in the five major departments, he said.
On July 4, Health Minister Chiu Wen-ta personally submitted a special report to the Executive Yuan about the latest developments of the Health Care Value-added Platinum Program, which has attracted widespread attention. The Platinum Program is the cornerstone of the Executive Yuan's efforts to develop health care, which it considers one of the country's six emerging industries.
Chen suggested that the program be modified to address the changes in the health care environment that have occurred in the nearly three years since it was first implemented. For instance, the program originally aimed to enhance medical care in remote areas, "but now problems are cropping up in metropolitan areas, as well," he said. He added that one such example is a severe scarcity of neurosurgeons, a problem one senior neurosurgeon described to the premier personally and whose solution requires changing the health insurance system and medical regulations.
"The Health Care Value-added Platinum Program cannot just stick to its original plan; it must adapt to new challenges and changes to provide meaningful service," he concluded.
According to official statistics, Taiwan's international medical service yielded revenues of about NT$4.64 billion (US$157 million) in 2011, and foreigners visited the island for care about 16,200 times, mostly from mainland China and Northeast and Southeast Asia.
The DOH has made plans to promote Taiwan's international medical care service in two major fields, terminal illness treatment and medical tourism, initially among overseas Chinese that reside in areas less than a four-hour flight from Taiwan before gradually expanding to the global market.
Critics of the plans say they would turn medical care into a service tailor-made for rich foreigners, who could crowd out ROC citizens and dilute the quality of care they receive. In light of these concerns, Chen has asked the DOH to explain to the public how its plans would benefit them and why the side effects anticipated by critics would not materialize. "Domestic care must come first," he reiterated, clearly establishing policy priorities.
The premier also acknowledged that if medical care service is to be considered an industry, medical regulations must be revised accordingly. Hence, he asked the DOH to hold public debates on this issue to find a social consensus that could serve as a basis to amend legal regulations.