本次代表健保局出席加斯坦歐洲衛生論壇第二次專家會議成果豐碩，同時順道拜會健保局贊助時段之單位OECD、歐洲衛生制度觀察團（EO）以及WHO顧問Guy Carrin，對於台灣於歐洲能見度之提昇頗有助益。本次專家會議確定張總經理鴻仁參加之Panel Discussion於十月八日週五上午舉行，將由一名學者擔任主持人，並統合整理十月八日健保局贊助時段之所有重要論述，俾利進行全面性討論。盧瑞芬教授同時推薦政治大學周麗芳教授參與。另於九十三年五月巴黎舉行之OECD Forum 2004，其衛生部長會議之主題為「Towards high performing health systems」，與加斯坦歐洲衛生論壇健保局贊助時段主題完全相同，對於張總經理參加OECD Forum 2004衛生部長會議將有助益。Report of the 2nd advisory meeting for the Gastein ForumJui-fen Rachel LuMay 5, 2004Before I offer some observations gathered from participating in the 2nd advisory meeting of Gastein Forum, I would like to express my deepest gratitude to Dr. Peter Chang, representative of DOH in Geneva for making all the arrangement for the pre- and post-meeting activities which essentially maximize the benefits of this trip and have made it quite a fruitful one for me, in addition to participating in the advisory meeting representing BNHI. I am also truly thankful to Ms. Yeh-Hsiu Liu for her able assistance in all the administrative arrangement which makes this trip as smooth as it can possibly be. In addition to the 2nd advisory meeting of Gastein Forum, we (Peter and I) have also visited European Observatory of Health Care Systems (hereafter as EO), OECD, and Guy Carrin (“Guy” is pronounced as “key” in French, “Carrin” has the stress on the second syllable, a senior health economist in the Geneva office of WHO).2nd advisory meetingThrough the pre-advisory meeting with Elizabeth Doctuer of OECD, Josep Figueras of EO and Matthias Schuppe of Gastein Forum, some consensus were reached and the revised program will be distributed shortly as agreed. Basically, we all have agreed that the themes and draft program put forth by Elizabeth are well presented and structured, hence the discussion in the pre-meeting mainly centered in the selection of the “right” speakers and discussants for the session and whether the stakeholders are well represented. The draft program has less representation of EO and Josep as a co-program organizer has made his stand clear regarding inviting some of the EO people as speakers. I think that Elizabeth eventually will accommodate Josep’s suggestion and there will be a good balance of OECD and EO representations in this session in the final turn-out which will be to the BNHI’s maximum benefits in terms of propaganda. The main revision for the BNHI-sponsored session is summarized as follows: 1) two additional presentations will be added and there will be no discussants for Panel B; 2) Panel D (which Dr. HJ Chang is one of participants in the roundtable discussion) will be held on Friday morning and an academician will be the moderator for this panel to really direct the discussion and pinpoint the issues raised previously in Panel A, B and C. I have proposed to have speakers in our session to provide country profiles before the forum for the participants and to instruct the speakers to focus on the specific issues assigned in the presentation (rather than doing the presentation on a specific country from A to Z, after all, no more than 15 minutes are allotted for each presentation). Peter specifically has proposed to do a monograph for the BNHI session which Elizabeth has agreed. Begin with the country profiles as the background and center at issue-oriented problem-solving approach, the monograph will put Taiwan’s experience in line with other parts of the world. I would also suggest to invite some of the local active researchers to join the forum to enhance the long-term endeavor in linking with European counterparts, people like Prof.周麗芳 who was trained in Germany and fluent in one of the official languages, Germany, used in the forum. Participation in the international arena will not be a one-shot event; hence Taiwan should always be prepared to bring in the new faces. I also believe that researchers will be greatly benefited from participating in such an international forum to embrace closely with a global perspective. European Observatory of Health Care Systems in BrusselsJosep Figueras, who was working in WHO region office in Europe, is one of the key persons in EO and has moved to Belgium since two years ago. EO’s work has focused on the Health Systems in Transition (HiT) for European countries, in particularly focusing on eastern European countries and central Asia ones. EO is known for its comparative studies in health care system and has released numerous publications. At its early booming stage and with a research-oriented mission, EO seems to be less bound by political bureaucracy. Taiwan researchers may consider pursuing a fellowship in EO to set a precedent in scholar exchange. OECDPeter Scherer, John West, and Elizabeth Doctuer hosted our visit in their Paris office. OECD with its major role in economic cooperation and development has been playing a limited role in the area of heath (mainly in health data collection), until the embarking of the OECD Health Project in spring 2001 which is the first one of its kind in in-depth comparative studies in health care system. The three-year OECD Health Project focuses on measuring and analyzing the performance of health care systems in Member countries and factors affecting performance and will culminate in a Meeting of OECD Health Ministers on 13-14 May 2004. The majority (29/30) of Member countries responded to a survey sent earlier this year have all indicated their consent in continuing the Health Project. Given the precedent set by the research fellows representing Taiwan’s Ministry of Economics in Paris, John West, Director of Public Affairs, sees no obvious opposition to taking research fellows in health-related field. When exploring the possibility of collaborating with Taiwan in its continuous efforts in setting NHA to conform to international standards, the door seems to be wide open (an option may be considered by the Office of Statistics in the Department of Health to establish the direct link with OECD). The 10th anniversary of NHI in 2005 was brought up in both the visits to EO and OECD (an opportunity of propaganda not to be missed). As a strong endeavor in pursuing the partnerships in the European continent, BNHI may consider extending the invitation to the European counterparts and welcome a European perspective in examining our NHI system. I would also agree with Peter in briefing Minister Chen before his presence in Gastein as Taiwan is more under the influence of US social value judgments which are quite different from those possessed by the Europeans. The focal issues need to be iterated. In fact, Dr. HJ Chang may well reap the fruits from attending the Ministrial Council Meeting 2004 on 13-14 May. The main theme is exactly the same as the session in Gastein Forum, “Towards high performing health systems”, with different participants and audience. Three subjects to be covered include quality of care, financial sustainability and improving value for money. Through the discussion process in the 2nd advisory meeting, I felt that they truly have handpicked the party members and expect them to be “smart” about the issues, i.e. right to the point, no hitting bushes. I think that our representatives should be prepared to join the highly selected crowd. Welcome on board, should I say.