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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GuyCarrin,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PanelDiscussion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OECDForum2004,其衛生部長會議之主題為「Towardshighperforminghealthsystems」,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OECDForum2004衛生部長會議將有助益。Reportofthe2ndadvisorymeetingfortheGasteinForumJui-fenRachelLuMay5,2004BeforeIoffersomeobservationsgatheredfromparticipatinginthe2ndadvisorymeetingofGasteinForum,IwouldliketoexpressmydeepestgratitudetoDr.PeterChang,representativeofDOHinGenevaformakingallthearrangementforthepre-andpost-meetingactivitieswhichessentiallymaximizethebenefitsofthistripandhavemadeitquiteafruitfuloneforme,inadditiontoparticipatingintheadvisorymeetingrepresentingBNHI.IamalsotrulythankfultoMs.Yeh-HsiuLiuforherableassistanceinalltheadministrativearrangementwhichmakesthistripassmoothasitcanpossiblybe.Inadditiontothe2ndadvisorymeetingofGasteinForum,we(PeterandI)havealsovisitedEuropeanObservatoryofHealthCareSystems(hereafterasEO),OECD,andGuyCarrin(“Guy”ispronouncedas“key”inFrench,“Carrin”hasthestressonthesecondsyllable,aseniorhealtheconomistintheGenevaofficeofWHO).2ndadvisorymeetingThroughthepre-advisorymeetingwithElizabethDoctuerofOECD,JosepFiguerasofEOandMatthiasSchuppeofGasteinForum,someconsensuswerereachedandtherevisedprogramwillbedistributedshortlyasagreed.Basically,weallhaveagreedthatthethemesanddraftprogramputforthbyElizabetharewellpresentedandstructured,hencethediscussioninthepre-meetingmainlycenteredintheselectionofthe“right”speakersanddiscussantsforthesessionandwhetherthestakeholdersarewellrepresented.ThedraftprogramhaslessrepresentationofEOandJosepasaco-programorganizerhasmadehisstandclearregardinginvitingsomeoftheEOpeopleasspeakers.IthinkthatElizabetheventuallywillaccommodateJosep’ssuggestionandtherewillbeagoodbalanceofOECDandEOrepresentationsinthissessioninthefinalturn-outwhichwillbetotheBNHI’smaximumbenefitsintermsofpropaganda.ThemainrevisionfortheBNHI-sponsoredsessionissummarizedasfollows:1)twoadditionalpresentationswillbeaddedandtherewillbenodiscussantsforPanelB;2)PanelD(whichDr.HJChangisoneofparticipantsintheroundtablediscussion)willbeheldonFridaymorningandanacademicianwillbethemoderatorforthispaneltoreallydirectthediscussionandpinpointtheissuesraisedpreviouslyinPanelA,BandC.Ihaveproposedtohavespeakersinoursessiontoprovidecountryprofilesbeforetheforumfortheparticipantsandtoinstructthespeakerstofocusonthespecificissuesassignedinthepresentation(ratherthandoingthepresentationonaspecificcountryfromAtoZ,afterall,nomorethan15minutesareallottedforeachpresentation).PeterspecificallyhasproposedtodoamonographfortheBNHIsessionwhichElizabethhasagreed.Beginwiththecountryprofilesasthebackgroundandcenteratissue-orientedproblem-solvingapproach,themonographwillputTaiwan’sexperienceinlinewithotherpartsoftheworld.Iwouldalsosuggesttoinvitesomeofthelocalactiveresearcherstojointheforumtoenhancethelong-termendeavorinlinkingwithEuropeancounterparts,peoplelikeProf.周麗芳whowastrainedinGermanyandfluentinoneoftheofficiallanguages,Germany,usedintheforum.Participationintheinternationalarenawillnotbeaone-shotevent;henceTaiwanshouldalwaysbepreparedtobringinthenewfaces.Ialsobelievethatresearcherswillbegreatlybenefitedfromparticipatinginsuchaninternationalforumtoembracecloselywithaglobalperspective.EuropeanObservatoryofHealthCareSystemsinBrusselsJosepFigueras,whowasworkinginWHOregionofficeinEurope,isoneofthekeypersonsinEOandhasmovedtoBelgiumsincetwoyearsago.EO’sworkhasfocusedontheHealthSystemsinTransition(HiT)forEuropeancountries,inparticularlyfocusingoneasternEuropeancountriesandcentralAsiaones.EOisknownforitscomparativestudiesinhealthcaresystemandhasreleasednumerouspublications.Atitsearlyboomingstageandwitharesearch-orientedmission,EOseemstobelessboundbypoliticalbureaucracy.TaiwanresearchersmayconsiderpursuingafellowshipinEOtosetaprecedentinscholarexchange.OECDPeterScherer,JohnWest,andElizabethDoctuerhostedourvisitintheirParisoffice.OECDwithitsmajorroleineconomiccooperationanddevelopmenthasbeenplayingalimitedroleintheareaofheath(mainlyinhealthdatacollection),untiltheembarkingoftheOECDHealthProjectinspring2001whichisthefirstoneofitskindinin-depthcomparativestudiesinhealthcaresystem.Thethree-yearOECDHealthProjectfocusesonmeasuringandanalyzingtheperformanceofhealthcaresystemsinMembercountriesandfactorsaffectingperformanceandwillculminateinaMeetingofOECDHealthMinisterson13-14May2004.Themajority(29/30)ofMembercountriesrespondedtoasurveysentearlierthisyearhaveallindicatedtheirconsentincontinuingtheHealthProject.GiventheprecedentsetbytheresearchfellowsrepresentingTaiwan’sMinistryofEconomicsinParis,JohnWest,DirectorofPublicAffairs,seesnoobviousoppositiontotakingresearchfellowsinhealth-relatedfield.WhenexploringthepossibilityofcollaboratingwithTaiwaninitscontinuouseffortsinsettingNHAtoconformtointernationalstandards,thedoorseemstobewideopen(anoptionmaybeconsideredbytheOfficeofStatisticsintheDepartmentofHealthtoestablishthedirectlinkwithOECD).The10thanniversaryofNHIin2005wasbroughtupinboththevisitstoEOandOECD(anopportunityofpropagandanottobemissed).AsastrongendeavorinpursuingthepartnershipsintheEuropeancontinent,BNHImayconsiderextendingtheinvitationtotheEuropeancounterpartsandwelcomeaEuropeanperspectiveinexaminingourNHIsystem.IwouldalsoagreewithPeterinbriefingMinisterChenbeforehispresenceinGasteinasTaiwanismoreundertheinfluenceofUSsocialvaluejudgmentswhicharequitedifferentfromthosepossessedbytheEuropeans.Thefocalissuesneedtobeiterated.Infact,Dr.HJChangmaywellreapthefruitsfromattendingtheMinistrialCouncilMeeting2004on13-14May.ThemainthemeisexactlythesameasthesessioninGasteinForum,“Towardshighperforminghealthsystems”,withdifferentparticipantsandaudience.Threesubjectstobecoveredincludequalityofcare,financialsustainabilityandimprovingvalueformoney.Throughthediscussionprocessinthe2ndadvisorymeeting,Ifeltthattheytrulyhavehandpickedthepartymembersandexpectthemtobe“smart”abouttheissues,i.e.righttothepoint,nohittingbushes.Ithinkthatourrepresentativesshouldbepreparedtojointhehighlyselectedcrowd.Welcomeonboard,shouldIsay. 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