NHI helping people live healthier, longer lives

Taiwan’s healthcare system is in the process of moving beyond focusing on treatments for illnesses toward helping people to live healthier lives. Over the past 30 years, the National Health Insurance (NHI) system’s greatest achievement has been ensuring that most people can access medical care and afford treatment.

In the past, regional hospitals were often the first point of access for healthcare. People with fevers, asthma, pneumonia or worsening chronic conditions would first receive treatment at their local hospital before being referred elsewhere if necessary. That was an important service in communities and helped lay the foundations for the accessibility of Taiwan’s healthcare system today.

Post-World War II baby boomers are entering old age. The challenge for healthcare is not simply helping people live longer, but ensuring that they can do so while remaining healthy and able.

President William Lai (賴清德) on Oct. 2 reiterated the goals of the Healthy Taiwan initiative: increasing average life expectancy by three years by 2032, and reducing the time people live in poor health. The move signals a transition away from the basics of NHI-enabled access to treatment toward a broader initiative of prevention, health promotion, rehabilitation, chronic disease management and healthy aging.

These shifts invite Taiwanese to reconsider the role of older physicians in the healthcare system. Kuo Ming-lung (郭明隆) is an alumnus of Kaohsiung Medical University and had served as an attending physician at Taipei Veterans General Hospital. He was appointed clinical associate professor at National Yang-Ming College of Medicine, where he contributed to teaching and medical training, and spent many years serving at regional hospitals, including as superintendent of Hsin-Tai General Hospital. His experience in working at major hospitals, teaching and contributing to community healthcare is a reflection of the evolution of the healthcare system.

Regional hospitals have faced different challenges over the years. In the past, their priority was to maintain acute medical services and ensure that communities had access to care. Today, they must contend with an aging population, chronic conditions, and increasing frailty and disability.

About one-third of physicians in Organisation for Economic Co-operation and Development member countries are older than 55, data showed, meaning that aging medical workforces and the question of succession are shared challenges. The solution is not a choice between retaining senior physicians or relying solely on younger doctors to fill the gaps. Rather, it is to foster collaboration between the two generations.

In February last year, Kuo returned to practice medicine with a position at Taipei Renji Hospital, under the leadership of Superintendent-General Lin Shui-long (林水龍). The significance of this development goes beyond Kuo’s career; it offers a reminder about the healthcare system: To preserve the continuity of medical expertise, hospitals must keep bringing in younger physicians while capitalizing on the judgement and experience of older doctors through joint consultations, case discussions and mentorship programs.

The focus of healthcare in Taiwan is shifting. The system must not only treat illnesses, but prioritize health, and ensure that the medical knowledge and experience accumulated by older doctors are passed on to the next generation.

Gerald Kuo is vice director of the Taiwan Home Health Care Charity Association.