Against Taiwan's Beloved National Health Insurance

“I’m Asian, I know a lot of doctors.”
Andrew Yang’s silly comment doesn’t withstand scrutiny, at least in Taiwan. There are only 1.7 doctors per 1,000. That’s half the OECD average (3.3).

Compared to OECD countries, Taiwan has fewer doctors and nurses. Physician- and nurse-population ratios in Taiwan are 1.7 doctors and 5.7 nurses per 1,000 population, compared to the median of 3.3 doctors and 8.6 nurses in OECD countries.

Although the population likes the system, doctors don’t.

The scenes bring to mind something I heard from trauma surgeon Li-Jian Chien, a member of the Taiwanese doctors union that formed in 2012 out of the frustrations felt in the medical profession.

In Taiwan, he says, “the patient [is] in heaven” — but “the doctor is in hell.”

Yet doctors and nurses don’t want to increase number of people in their professions. They complain about their workload, yet don’t want it reduced.

Some policy makers and experts, as well as professional associations in Taiwan, including nurses associations, are opposed to increasing the number of new entrants into their professions.

Taiwan also can’t import nurses from the Philippines like the US does, due to language difficulties.

Of course, there are upsides of the NHI, like consumer satisfaction, relatively shorter wait times, world-leading hospitals, great public health, and low administrative costs.

in what context did the Yangster say that?

During one of the debates (the only debate I watched). It was meant to be a joke, playing off stereotypes.

Meh. Nurses in Taiwan do jack-shit, apart from injections, checking your IV drip, and taking your blood pressure and temperature. You’re expected to have family members doing your bed-pan duties, washing you and feeding you. If they aren’t around, you’re expected to hire a private nurse.

The first time I was in hospital (for neurosurgery) they wouldn’t even bring my (privately ordered) biandang to me. I had to roll out of bed and crawl to the hallway to collect it.


When you get sick you are x-rayed, ultra sounded, blood, urine, etc in like an hour. And that costs like what 300 NT?

Most - but not all - places you would be waiting months or paying thousands for the same thing.


That’s probably cuz they’re busy doing other stuff, because there aren’t enough of them.

Also, you can hire Filipina help to feed you.

Still the shortage of doctors is neither ideal nor sustainable. The population is aging fast.


Same experience. Its even more pronounced in China. I recon in Taiwan they would step in if there was no family to do it.

Taiwan’s system is great for these things.

  1. Cost.
  2. Efficiency
  3. Covers serious illnesses completely with first world medical care.
  4. Simple for minor illnesses like a cough or skin irritations.
  5. jianbao card is such a great idea.

It’s however bad for these things.

  1. Many medication just aren’t available at all even out of pocket because Taiwan wasn’t able to negotiate a deal.
  2. Medical issues that’s not major but also not minor. These are a pain and you don’t get enough individual care needed due to so many people using the system for minor things. You really need to be your own advocate and push for your own treatment from research.

The three day prescription thing is a bad idea for antibiotics. Hospitals prescribe the full course but the local clinics prescribe half + come back later. And that is not how antibiotics should be prescribed. (just looking for a downer :grin:)

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The thing is, there are antibiotics that can be taken for a only 3-4 days now. But I think it’s not the one the government covers for NHI. I also think the medical community now believes you don’t and shouldn’t take antibiotics for so long.

Also hospitals tend to try to give medications they can make the most money from government reimbursements instead of maybe the best medicine for the patient first.

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By the way, does Taiwan have PAs and nurse practitioners? IOW, “not doctor” doctors, so physicians can keep their appellation cartel?

yea exactly, its the only fault that I can see in the system. Otherwise its an astonishingly effective system. Like way better than anywhere else I have experienced (Ireland, US, Netherlands, China) and the bottom line you don’t need money to access it, quickly.


Why don’t you just ask for a prescription so you can buy it from someone else, like at Walmart?

They give a three day prescription and if you pay a few hundred more you get a full course. But in my experience they think doing that is nuts.

The hospital has its own pharmacy here. Some clinics have a small pharmacy for basic drugs. If you just wanted antibiotics, you can probably forgo going to the doctors with many pharmacies willing to sell you the drugs. It depends on the pharmacy and your relationship with them. My pharmacist just gives me what I want.

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Found that one out recently. Never imagined it was possible, and then, like Oh just ask them for whatever drug you are looking for… WTF :laughing:


Glad you like it, but I don’t think the numbers bear out Taiwan’s system being among the best.

Aside from public health (which Taiwan was good at even before implementing the current system), Taiwan ranks in the lower tier among OECD countries.

This isn’t really about NHI, but I love how less restrictive the pharmacies in Taiwan are. You don’t need to always go to the doctors and just get what you need. But of course it’s out of pocket but it’s honestly no more than the 200nt you spend seeing a doctor with NHI.

Also codeine is OTC here, I get allergies and it irritates my throat giving me a cough. The only thing that really helps suppress the cough is codeine, it works really well. Most countries are so restrictive on codeine now its ridiculous. Drugs addicts aren’t able to get high off codeine if they’re shooting heroin.

I’ve lived in four OECD countries: Ireland, France, Netherlands, US, and they all hit the wallet really really hard. Or if not hitting make you wait. So Based on experience Taiwan is actually number one on this for me