Speaker：Yip Ping-Keung (Fu-Jen Catholic University, Taiwan)
Paper Title: The past, present and future challenges to religious hospitals in Taiwan

Abstract：

Tracing back the recent medical history of Taiwan, from 1865 to 1895 was called the period of “Missionary Medicine”. Dr. J.L. Maxwell, a missionary doctor from the English Presbyterian Church who established the first western-style hospital in southern Taiwan, the Sin-Lau Christian Hospital (1865). Later the Mackay Memorial Hospital in northern Taiwan (1880) and Chang Hua Christian Hospital in central Taiwan (1896), they were all belongs to the Presbyterian Church. This period was the prototype of Charity and Health Care in Taiwan. The first Catholic church-established hospital started from 1949 in Kaoshiung. Under “The Taiwan Christian Health Care Alliance”, we have a total of 27 members (hospitals) all over Taiwan by the end of 2012. The Buddhist medical system started to join the health care system since 1970’ in eastern part (relative remote area) of Taiwan, but the Tzu-Chi Hospital has been rapidly increased to 6 related branches in Taiwan, being the second largest health-care provider after the Presbyterian Church. The religious –related hospitals accounted for a significant number of total beds in Taiwan even in the present era. The roles of religious-hospital in the era of “Missionary Medicine” in Taiwan were similar elsewhere in the past, i.e., medical care (service) and evangelization. In late 19th to early 20th centuries, political and economic conditions in Taiwan were unstable, both medical personnel resource and supplies were relied on foreign countries, or imported status. In this period, no regular medical education was provided until the Japanese regime, missionaries became part of the important sources of medical personnel and they trained a minor portion of local doctors and nurses to serve in the religious community-operated institutions. The period of Taiwan under Japanese rule (1895-1945), formal medical educational system, public health system and “public doctor” were instituted by the Colonial government which provided medical personnel resource and better sanitation system, infectious diseases control was improved to a certain extent. The charity-related health system provided by the religious communities was relatively suppressed in this period. The present Taiwanese (Republic of China) government began to launch medical insurance systems in Taiwan around 1950’, the Labour Insurance (1956), the Government Employee Insurance in 1958 and later the Farmer Insurance (1985). These medical insurance systems covered both the outpatient and inpatient charges that greatly ensured the health welfare of certain populations. But these insurances only covered 20-50% of the general populations; the religious related hospitals were giving service to bridge the gap of medical care in this period for the poor sector. The following factors greatly impact the religious-operated hospitals in the recent decades, i.e., the launch of National Health Insurance in 1995, more than 98% of the general populations were covered by the national insurance system; the rapid development of transportation shortened the difference of urban and rural areas; the rapid installation of medical equipments and service-oriented in most hospitals provide modern medical care to the patients are great challenges to the religious-operated health care sector in Taiwan.