Taiwan’s health insurance system highlighted at world meeting
台灣健保經驗世界性會議中備受矚目
By 中央社
編譯: 廖文韻
2009-04-18
A senior official from Taiwan gave a presentation at the annual conference of the World Health Care Congress (WHCC) Tuesday on the country’s well-developed health insurance system. 台灣高層官員週二在「世界健康會議」的年會中，介紹台灣發展完善的健保系統。
Chen Hsiao-ping, vice president of the Bureau of National Health Insurance under the Cabinet-level Department of Health, explained in detail the historical background of the national health insurance system, its special features, factors contributing to its success and the challenges it faces. 中央健康保險局副總經理陳孝平，詳細說明台灣健保系統的歷史背景、特色、成功因素及面臨的挑戰。
His address drew much attention as it came at a time when President Barack Obama’s administration is actively promoting reform of the United States’ health care system. 由於目前歐巴馬政府正積極推動美國醫療體系的改革，因此陳孝平的演說引起熱烈迴響。
Chen used diagrams, graphs and solid figures to give an extensive and vivid analysis and to make comparisons between the health insurance systems in Taiwan and the U.S. 陳孝平利用圖表與數據，清楚地提出綜合分析，並針對台灣與美國的醫療保險制度作比較。
His presentation impressed many foreign public health officials and medical professionals at the WHCC conference, which is also being attended by health care industry representatives from across the United States and around the world with a view to exchanging opinions and experiences in medical service development. 世界健康會議的年會中，許多國外公共衛生官員以及醫界人士，都對陳孝平的演講印象深刻。世界健康會議年會的與會人士，包括來自全美以及世界各地的醫療保健業界代表，針對醫療服務的發展，進行意見交流與經驗分享。
A number of participants asked Chen questions during the Q&A session following his speech and expressed admiration over the wide coverage, efficiency and relatively low premiums that are the hallmarks of Taiwan’s national health insurance system. Many of them also said it is worthy of emulation by the United States. 演講之後的提問時間中，許多與會者爭相發問，並表示對台灣健保體系保障範圍廣、效率高、收費相對低廉，感到十分羨慕。許多與會專家認為，台灣健保經驗值得美國借鏡。
Sweden and the UK have similar systems, although not quite as good these days.
It’s amazingly cheap here, both medical and dental care and mostly a very positive experience, so why shouldn’t more countries try to follow Taiwan in one of the fields where its government has done something really well?
Is there any health system that isn’t BROKE in the world, that are not supposed to be for profit. Taiwan’s is probably one of the least broke ones!
The system here is excellent general care, covers almost all the population (except for certain unemployed families unfortunately), easy to get expert advice and surgery, excellent diagnostic facilities. I recently had surgery on a benign tumour, the guy spotted it quickly, sent me to the specialist, the specalist did the surgery quickly and efficiently and no charge!
It costs 2000 ntd to go to a GP in my home country, just to walk in the door and tell the doc you have a problem, then you have to pay for the drugs! We pay higher national health premiums aswell and many people have the burden of private insurance too! The only people who get free medical care are the long-term unemployed and low income families.
Sure there are problems as mentioned above and also with over-prescription…if you can afford the very best care and want top priority you can always pay for it too, but remember many of the private clinics do not have the best facilities or doctors and may send you back into the public health system!
Oh, the satisfaction rate is quite high for the Taiwan system because there is no gatekeeper and it covers 96% of the population. I can decide I want to see a specialist by phone, and if I don’t like what he says, I can go see another in the afternoon. No one will stop me. That is why you wait 45min for a 5min visit. This is one reason why the misdiagnosis rate is so high is Taiwan. On the topic of misdiagnosis - just see what happens if something goes wrong with your operation and see what recourse you have. Yes, there are a lot of very professional doctors in Taiwan, but there are also many hacks.
Yes, the taiwan system is very good for small illnesses. Just try getting truly sick. Long term illnesses and very serious diseas states are very expensive in Taiwan and all OOP after a relatively short period of time.
As for the finances; it’s only been around since what, '97-'98? and didn’t go into an annual deficit until 2000 or so - so it’s just started going broke; but if you look at the trends. Ouch. What will be really fun is that the income is essentally payroll based and capped at a relatively low level on income so as Taiwans payrolls decline…
I’m not saying that other sytems work, I just saying that the Taiwan system as it stands is not sustainable. Even the govenment agency that runs it says that. Anyway, its really not a healthcare insurance system, its more a form of social welfare or benefit. Taiwan will need to decide if it wants to fund it as such. It badly needs reform but no one dares tackle the issue since it is so popular.