ABSTRACT
National health insurance (NHI) system is an important part of Taiwan’s social security system and now facing the predicament of financial imbalance. The policy makers have been practiced different policies to improve the predicament. However, the problems the NHI system facing are complicate and dynamic. In this research, we use Thinking Processes proposed by Dr. Goldratt as a prescribe model of human thinking to help people think over the problems of the Policy of Chronic Illness Refill Slip of NHI. We apply the Thinking Processes to national health insurance system. We practiced Step1 (What to change?) and Step 2 (What to change to?) of logic thinking in Thinking Processes to develop the strategic injection (SI). Following that, we analyzed data from the database of NHI of Hypertension to verify if the SI works. With the Thinking Processes we got the following findings: the core conflict for the Policy of Chronic Illness Refill Slip is between “both doctors and patients don’t have the willingness to use the refill slip” and “trying to raise refill slip approved ratio”. The strategic injection which might solve this problem is “to fix patients to a specific medical institute for outpatient services”. Analyzed the data, we found that when the number of medical institutes a patient
goes increased the average number of outpatient service increased and the number of medical institutes a patient goes increased the average ratio for taking refill slip decreased. If we can fix the patients to a medical institute for outpatient services, we can improve the excess expenditure for NHI system.
