The Taiwan Health Reform Foundation:Keeping a Ten-Year Promise

Formerly a member of the Department of Health's Medical Affairs Review Committee and Medical Dispute Review Committee, and now a researcher at Academia Sinica's Institute of Sociology, Chang Ly-yun has always felt that she should be doing something that would get more results in upgrading the quality of medical treatment and pursuing social justice.

In October 2001, Chang, along with a few like-minded friends, finally turned ideas into action and raised funds to establish the Taiwan Health Reform Foundation, an organization that would speak out on behalf of the public.

Voice of the people

The THRF's mission is "to promote the establishment of a quality and just medical environment in Taiwan." Chairwoman Chang Ly-yun states, "The Taiwan Health Reform Foundation aims to bring about an environment in which every physician has an opportunity to become a good doctor, and in which doctors with a social conscience are the rule, not the exception."

The THRF has always sought to consider matters and speak out from the point of view of people's needs, and to maintain a balance in the triangular relationship between the government, medical community, and general public. In the span of a few years, the THRF has achieved much.

Near the end of 2000, seeking to awaken the public to their medical treatment rights, the THRF published for the first time the results of a public survey of the quality of medical treatment provided by public and private hospitals. In 2002, the second public survey of treatment quality was published. The THRF also began to promote the labeling of prescription drug packets. The following year a new version of a surgery consent form was proposed which curbed the number of unnecessary operations that were taking place. After that, the group broke down barriers that kept people from obtaining their medical histories, and began to publicize and scrutinize the financial reports of hospitals.

Looking for friends

The THRF's website displays the following declaration: "To maintain impartiality, the THRF does not accept subsidies from government programs or sponsorship from interest groups."

All of the THRF's directors and administrators are non-salaried volunteers. The pay for its five full-time staff is far lower than what they could receive elsewhere. The office fridge was even graciously donated by a relative of one of the employees. Yet, in spite of all this, without rice the cleverest housewife cannot prepare a meal. Without financial support from the government, the "advocacy-oriented" THRF's path is a lot tougher than typical "service-oriented" non-profit organizations.

"Constant worry about daily operating funds can greatly harm an organization such as ours," says Chang Ly-yun. "Our aim is that our expert members who want to 'turn knowledge into action' can spend their precious time on action and strategic planning rather than figuring out how to raise money to cover their daily expenses."

However, there is always a large gap between ideals and reality, especially in the area of fundraising. It seems like there is still a long way to go in leading the public from "awareness" and "agreement" to the next step of "support" of THRF through monetary donations.

"We do not have enough public recognition, and on top of that there is a bit of a gap between our policy advocacy efforts and the general public. We also lack a famous spokesperson or a well-known case with public sympathy. Consequently, fundraising efforts are especially difficult," states Chen Ya-jing, chief of the THRF's Division of Education and Advocacy, who shoulders the fundraising work. The THRF requires over NT$5 million a year, but it is tough to raise that much from individual donations. The "Friends of Health Reform" group, which makes periodic donations to the THRF, has only 121 people and comes up with an average monthly total of only around NT$120,000.

Chairwoman Chang Ly-yun often reminds members to fix on the THRF's mission as the most important goal, with everything else being secondary. She has even told people to be ready for "red-ink budgets." "Non-profit organizations shouldn't be afraid of not having enough money and so disburse funds sparingly. Instead, they need to use funds effectively and produce tangible results." Chang states that non-profit organizations are not established for the purpose of raising funds, and they certainly should not raise funds solely to give people salaries.

However much money is available, that's how much work will be done. Last year the THRF was fortunately able to cover their costs with an income of over NT$5.6 million. Of that, 71% came from donations, 26.4% from the Asia Foundation, and 2.7% from interest income. Chen Ya-jing points out that due to the Little Girl Chiu incident that occurred in February, the THRF has gained wider recognition and donations have slightly increased. In addition, the THRF's charity sale of a health-themed calendar raised a lot from businesses; the THRF will allocate the resulting funds towards promoting medical treatment safety.

The THRF perfectly embodies a non-profit organization's spirit of selflessness and desire to benefit the public. Our society needs these kinds of NPOS, just as they need our support in return.