Why is Taiwan NHI relatively affordable? (I assume its low pay in the medical industry, incentives to prescribe lots of drugs)
Like if one was to buy private insurance in Taiwan (had no NHI), what do you think would be the difference in cost?
Maybe it’s lack of lobbying and profiteering from the insurance industry? Medical insurance is extremely expensive in the US because they can.
I have no idea of private insurance in Taiwan but even visiting doctors or having treatments done in Taiwan as uninsured person is cheaper than US insured costs. Universal healthcare lowers costs for everyone.
Americans are going to Canada for healthcare sometimes because even if you self pay there, it still comes out a lot less than US.
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One of the most important reasons is bureaucratic efficiency. IIRC the whole program is run by a few hundred people.
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As I work in Ad firm, I also notice in some nations where is private insurance they spend a lot on ads and marketing, there is non of that in Taiwan or UK.
They are all not for health, but ads for insurance firms in US are in the billions (USA$)
Also curious if a USA resident, would you have insurance there and why double spend on this?
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The answer is yes. It is absolutely worth it, as long as you’re not double paying for health insurance in the US at the same time.
The main reason I moved to Taiwan from the US was to take advantage of NHI here. My monthly premium here is around $800. If I bought health insurance in the US, it would be closer to $800USD.
Well I lost my medical coverage from Australia as I don’t live there so cannot access the medicare system there. I’m in my 60’s and have used the NHI here a lot recently due to a leg infection. NHI Also covers dentistry which Medicare in Australia does not cover.
It’s so cheap and the medical service is great. For one thing, in many countries you cannot book into see a specialist directly you need a referral from a GP. Here you can book to see the specialist you want, do it online, get a date and time and have an app that lets you know what number they are up to so you don’t have to be sitting waiting for a long time…
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NHI is not insurance, its more of a tax, the earnings of which are used to fund the medical system.
if you want to be a citizen, you need to accept it as part of rhe deal.
i assume you are not required to do military service, cuz its also part of the deal of beong a citizen.
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It’s pretty similar to the public health systems of other countries and has its pros and cons as well.
Overall a good system and from what I’ve read about the US system, substantially better than that.
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It’s only 4 months, going up to a year.
I think if you’re stuck with us health system, it’s probably worth it. I had to do a year and a half.
People join the military in the us so they can have the healthcare. In the us military you will be risking life to fight pointless wars.
You will not fight any wars in the Taiwan military.
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I guess if you’re a citizen and live in Taiwan you have to get NHI. Additional private health insurance makes it a really good. Just buy additional local insurance, good value.
My meds cost me 200-250 NT$ a month, including doctor’s consult.
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nhi is like 20~30 USD a month. granted the doctors have really gone downhill for a while. but you get nearly free things like MRI, scans, tests etc. even with the shitty doctor quality becoming a problematic issue, it’s worth it for the equipment and short wait times. if your second citizenship country has quality humans on staff, use them for diagnosis and come here for the better mechanical/digital aspects of health care 
Or, as suggested, additional coverage which will cover the pay doctors here. there seems to still be a decent number of good ones with legitimate listening skills, but it takes time to wade through the useless key pad punchers
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The NHS is good here IMO, when supplementing the NHS with private insurance you’re not buying into a separate system. Private insurance will get you a private room for example in a hospital where most people are on NHS only. Same doctors and equipment.
But a better example might be something like a worn out spinal disc. The doctor might give option A which is covered by NHS and they operate on the spine and staple the above and below vertebrae together, problem solved but not great for mobility.
Option B is to order an expensive replacement disc for 1/2 million NT$ or so, which needs to be paid for out of hand or with insurance, but better mobility. Either way its the same hospital and doctor’s doing the procedure and they are not allowed (it seems) to suggest one opinion over the other.
Such trade offs on cost are common and perhaps one reason the NHS keeps costs down. Need a colonoscopy? Well theres option A without the anesthesia and then theres option B where you pay for something not considered an absolute necessity.
But as noted the NHS coverage is pretty good and extensive but its not something you get rid off in place of private insurance.
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That is very true.
But on top of that, I have found the pay doctors almost 100% of the time better than the NHI ones. in terms of they actually ask and care and find the answer rather than just push some pills 3 or 4 times before taking your words seriously.
if it turned out to be true that they are the same doctors and they just switch on and off their level of attentiveness ,then I would say the problem is far worse than what i thought originally. that would be horrid if true, and absolutely unacceptable.
But I agree, the systems is overall better than most. my concern is the downward spiral in quality of professional in the last years. have hear untold amounts of similar complaints from a fairly wide range of people. it’s been quite saddening to hear and also experience first hand so often.
It’s affordable because the healthy subsidise the old, the infirm, the unhealthy, the sick, etc… Everyone has their turn, but it keeps it cheap. It’s more efficient that way. We all do get sick eventually. A public insurance scheme only works when everyone is on it.
There’s more details here.
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You definitely don’t want to share a room with anyone, believe me.
One of the reasons is that Taiwan negotiates drug prices with manufacturers and they often cover older generation of drugs that the patent expired on instead of new patent ones. Taiwan also has pharmaceutical companies that produces these generics the system use.
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They actually do limit the payouts for drugs and doc services …I saw a post from a doc that says they have a points system for services performed, it was originally 1 point equal 1 NT but now it’s more like 1 pt equals 0.6 NT or something i.e. they are getting the same income or even less income year by year.
I think they need to discourage doctors padding stuff out to try and get more money from NHI. For example you really don’t need to see a doctor every 2 weeks for blood pressure medication or antidepressants (those need at least a month to even start working).
Just issue a long term script and be done with it.
Did you have a bad experience sharing?
I wonder , when did individual rooms start becoming a common option?
I’ve stayed in a ward room with 4 people twice in Taiwan, I didn’t mind it personally…Just pulled the curtain and didn’t get bothered. I don’t have private insurance though and didn’t fancy paying extra for it.