Wang Naisan?
Abstract
The current situation of Taiwan's healthcare system is quite confusing. Although many dedicated people have been working hard to improve it, because of the complex and rapidly changing background of the healthcare system itself and the society as a whole, the old and new concepts as well as the hardware and software of healthcare are often subjected to multiple impacts at the same time, and it is difficult to clarify what is progress and what is regression, what should be preserved and promoted, and what should be eliminated.
The Dutch landed on southern Taiwan in 1624 and drove the Spanish away in 1642, occupying Taiwan for nearly 40 years. At that time, Western medicine in the Far East was known as "orchid medicine," and the Dutch also set up hospitals in Taiwan, but the vast majority of Taiwan's aborigines still relied on shamans to drive away ghosts and spirits and ate herbal medicines to cure their illnesses.
Zheng Chenggong in 1661 from the Penghu capture Chikan drive out the Dutch, Han people began to immigrate to Taiwan. 22 years after the Qing court will be incorporated into Taiwan, Han people moved to Taiwan increased successively, the immigrants are mostly young bachelors, many of them married with the aboriginal girls, so there is "only Changshan Gong (grandfather from the mainland), there is no Changshan mother-in-law
The first real contact between Taiwan and Western medicine was in 1865, when the British Presbyterian Church sent Dr. James L. Maxwell to Taiwan for medical conduction and to set up a hospital to treat the Taiwanese. At first, Christianity and Western medicine were quite rejected and hindered by society and Chinese medicine, but through the efforts of Rev George L, Mackey and Dr. David Landsborough, not only did the number of believers increase, but they also trained a number of Taiwanese doctors to take care of the sick all over the island, however, Chinese medicine or Taiwanese traditional Chinese medicine (TCM) still had a great influence in the countryside.
In 1895 the Qing Dynasty was defeated and ceded Taiwan to Japan. Taiwan declared independence, but the independence forces were quickly routed by the superior Japanese army. However, the Japanese, whose deaths from infectious diseases such as malaria and cholera far outweighed the casualties generated by combat, resolved to improve Taiwan's sanitary conditions. Although the Japanese used highly repressive means in 1898 to attach the health section to the police department, each state and city police department, the health section was divided into four departments: health care, medical, opium, and epidemic prevention, which were enforced by the police, according to the situation at that time, it was really effective, and it can be said that it planted the foundation of the local grassroots medical care and health administration in Taiwan. The Japanese ruled Taiwan for fifty years on the training of Taiwan's medical personnel is also quite try, Taiwan people to stay in Japan to study medicine is also a lot of these people have become the end of the Second World War at the beginning of the medical profession and even other sectors of society's leading figures.
With the end of World War II in 1945, the Taiwan Provincial Health Department set up 22 health bureaus and 351 health centers throughout the province in 1947 based on the foundation left behind during the Japanese colonial era, and strengthened medical care in mountainous and remote areas, which was quite complete in terms of scale and organization. Since 1950, the government has also been providing labor insurance, public employee insurance, and farmers' insurance, which has helped about half of the population to avoid the fear of getting seriously ill and not being able to afford medical treatment. However, with the improvement of society and economy, the high-tech testing of medical care, and the increasing demands of patients, the medical ecology changed, resources were wasted, and the relationship between doctors and patients deteriorated, and after the implementation of universal health insurance in March 1995, the disadvantages seemed to have increased. At the same time, due to the rapid development of industry and commerce, the increase in the number of vehicles, air pollution, water and rivers filled with industrial waste and other problems after 1980 is also more serious, the people began to air, drinking water, and even the food, land, etc. are suspected of living in the degree of food insecurity.
Since the end of World War II, the number of Chinese medicine practitioners has increased dramatically due to government support. Chinese medicine practitioners are qualified by passing a special examination, and their training is uneven, and their appraisal and management are not on track. There is little cooperation between Chinese and Western medical practitioners, and patients often go back and forth between the two without being able to distinguish between the good and the bad. Not only that, but also asking God to drive out ghosts, borrowing Buddha's light and qigong to cure illnesses, selling incense powder and magic water, as well as special anti-oxidant and immune-boosting drugs from mainland China, Europe, and Central and South America with unclear compositions, all of which have been able to make a lot of money in Taiwan. After the implementation of the national health insurance, the corporatization of the large hospitals, patients, regardless of the size of the disease, are to the famous doctors, well-equipped hospitals crowded, primary health care is often forgotten and suffered a severe blow, medical education, especially post-graduation education is also due to the distortion of high-tech medical care into only training specialists, only look at the heart, lungs, gastrointestinal and other single-organ problems, rather than looking at the patient as a whole doctor.
The purpose of medicine is to alleviate the pain of patients and prolong healthy life, but the medical system in every country in the world has its own criticisms, and recently Japan and the United States are also reviewing the whole set and praying for improvement. Analyzing the problems of the medical system in different countries, it is only due to the high expectation of patients on medical personnel and medical technology, insufficient medical funding, and the decrease of trust caused by the mutual respect between human beings. In fact, the life expectancy of human beings has been increasing, and the technology to alleviate diseases and prolong life has been advancing, however, it seems that in order to increase the life expectancy, the suffering of oneself and one's family has increased, which has gradually become a serious problem.
Theoretically, the vision of a healthcare system is simple. Because we all have a pretty good ****ing idea of what the problem is. But the problem is mostly man-made, and it's not easy to change people and their minds. We have to consider the balance between the following issues for the whole society and the whole person: industrial growth and environmental pollution, high-tech medical care and health insurance payment, ethics, society and law, prolonging life and aging, community-based primary care or general medical care and specialties and sub-specialties, Chinese and Western medicine, and other medical drugs and methods. Changing people starts with education. Medical personnel must be educated and all people must be educated, and the earlier we start, the better, so that everyone can respect and care for each other, and the spirit of the rule of law must be able to understand the balance between individual expectations and reality. In addition to education, we need to face the reality, establish a correct and objective evaluation method, and establish a strictly enforceable improvement mechanism, including evaluation payments, treatment principles, regular tracking, and regular improvement.