Lai's Medical Reform Uses Experience-Based Pay to Attract Doctors

President Lai Ching-te delivered a speech in Taipei regarding healthcare reform, reiterating that as a politician with a background as a physician, he must rely on practical experience to improve the National Health Insurance (NHI) system and enhance the working environment for medical personnel. This speech not only reviewed his career in the Ministry of Health and Welfare (MOHW), local health departments, and the Executive Yuan, but also highlighted the Democratic Progressive Party's long-standing commitment to healthcare issues. Since serving as Minister of Health and Welfare in 2019, President Lai has repeatedly advocated for a "different pay for different work" compensation system and promoted the rational allocation of healthcare human resources during his tenure, hoping to reduce the workload of medical personnel and elevate medical quality through institutional innovation.

In Taiwan, the National Health Insurance (NHI), implemented since 1995, has become one of the most comprehensive and cost-effective single-payer systems in the world. However, with population aging, an increase in chronic disease patients, and rapid advancements in medical technology, the demand for medical manpower has risen simultaneously. In particular, shortages in remote areas and among specialist physicians have long been major bottlenecks causing unequal medical services. President Lai pointed out that the government will continue to increase the total NHI expenditure cap and implement the "different pay for different work" compensation model into actual reimbursements, hoping to attract more physicians to understaffed specialties and improve human resource allocation in hospitals and clinics.

The core of "different pay for different work" lies in adjusting compensation structures based on a physician's working hours, professional skills, and scope of service. This not only enhances job satisfaction among physicians but also helps reduce the turnover rate of medical personnel. President Lai emphasized that the government will prioritize the use of increased revenue for employee salary raises, continuing education, and workplace environment improvements, while encouraging medical institutions to invest funds in upgrading medical quality, such as introducing advanced medical equipment and optimizing medical record management systems. This move also aligns with the government's "people-centered" healthcare policy guidelines, aiming to alleviate the work pressure of physicians while safeguarding medical quality.

On the political front, President Lai's healthcare reform proposals have garnered support from the majority of opposition parties, as the shortage of medical manpower and issues concerning service quality have become focal points of social concern. However, some conservative lawmakers remain reserved regarding increased NHI expenditures, worrying that long-term financial burdens could impact national fiscal stability. To address this, President Lai proposed that through adjustments to NHI reimbursements and medical cost management, the new expenditures will be ensured to remain within a controllable range. If successfully implemented, this strategy will help balance the dual objectives of enhancing medical quality and fiscal sustainability.

Overall, President Lai's healthcare reform is not only a self-affirmation of his identity as a physician, but also a substantive response to the long-standing dilemmas of Taiwan's medical system. Through "different pay for different work" and the continuous increase of the NHI total expenditure cap, the government intends to forge a more attractive medical working environment, thereby resolving manpower shortages across specialties and institutions. If implemented smoothly, it will bring significant improvements to the fairness, accessibility, and quality of Taiwan's medical services, while infusing practical results into the Democratic Progressive Party's political commitments in the healthcare sector.