Taiwan Healthcare

Healthcare in Taiwan is administrated by the Department of Health of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease.

In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were a total 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totalled $752 in 2000. Health expenditures constituted 5.8% of the gross domestic product (GDP) in 2001 (or $951 in 2009); 64.9% of the expenditures were from public funds. Overall life expectancy in 2009 was 78 years.

Recent major health issues include the SARS crisis in 2003, though the island was later declared safe by the World Health Organization (WHO).

The current healthcare system in Taiwan, known as National Health Insurance (NHI), was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralises the disbursement of healthcare funds. The system promises equal access to healthcare for all citizens, and the population coverage had reached 99% by the end of 2004. NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for both public and private providers.

Most health providers operate in the private sector and form a competitive market on the health delivery side. However, many healthcare providers took advantage of the system by offering unnecessary services to a larger number of patients and then billing the government. In the face of increasing loss and the need for cost containment , NHI changed the payment system from fee-for-service to a global budget, a kind of prospective payment system, in 2002.

At the beginning of 2006, satisfaction decreased to the mid-60% range because the program needed more money to cover its services. Since then, satisfaction has gone back to the 70% range. Enrollees are satisfied with more equal access to healthcare, have greater financial risk protection and have equity in healthcare financing.

Even with all their success in its healthcare system, Taiwan has suffered some misfortunes. The government is not taking in enough money to cover the services it provides, so it is borrowing money from banks. The revenue base is capped so it does not keep pace with the increase in national income. Premiums are regulated by politicians and they are afraid to raise premiums because of voters. The country is slow at adopting technology except for drugs. There is a low doctor-to-population ratio resulting in too many patients depending on too few doctors. Patients visit the doctor more frequently causing doctors to keep visits short to about 2 to 5 minutes per patient. There is no system to regulate systematic reporting of clinical performance, patient outcomes, and adverse events.


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