
Writing in the well-respected Dissent Magazine http://dissentmagazine.org/, Ian Williams suggests that Taiwan's health care system might serve as a model for expanding access to medical treatment in the United States. Taiwan does seems to have the ideal health care plan with nearly universal coverage, no waiting periods except for organ transplants and cost efficiency.
Williams writes:
"Taiwan inaugurated its National Health Insurance program in 1995. Before then the three major social health insurance programs, Labor Insurance, Government Employee Insurance, and Farmers Insurance, left 40 percent of the population uncovered, many of them children and retirees. Dr. Michael Chen, vice president and chief financial officer of the NHI Bureau, says that there is now 99 percent coverage—he is not sure who the missing 1 percent are, but suspects that they are expatriates who have not registered (apparently, prison inmates are not covered but do receive care in the prison system). Indeed, many expatriates maintain their coverage—including the million or so who now work in mainland China. Conversely, foreign workers in Taiwan are also covered."
Williams writes:
"Taiwan inaugurated its National Health Insurance program in 1995. Before then the three major social health insurance programs, Labor Insurance, Government Employee Insurance, and Farmers Insurance, left 40 percent of the population uncovered, many of them children and retirees. Dr. Michael Chen, vice president and chief financial officer of the NHI Bureau, says that there is now 99 percent coverage—he is not sure who the missing 1 percent are, but suspects that they are expatriates who have not registered (apparently, prison inmates are not covered but do receive care in the prison system). Indeed, many expatriates maintain their coverage—including the million or so who now work in mainland China. Conversely, foreign workers in Taiwan are also covered."
"NHI premiums cover Western- and Chinese-style medicine, both in- and outpatient, prescription charges, home care, and dentistry. Almost all western-style hospitals and 88 percent of Chinese-medicine clinics are in the system. "
"Though dentists have been opting out of the British National Health dental system in large numbers, almost 95 percent of dental clinics are in the Taiwanese system. Health care is provided by a competitive mixture of municipal and public (about one-third of the beds) and privately owned hospitals that also offer comprehensive primary care. Between them they employ almost two-thirds of doctors."
"Avoiding the severe conflict of interest that the British system has maintained, doctors contracted to hospitals cannot run private practices on the side. TAIWAN IS a smaller (twenty-one million people), more compact country than the United States, but the NHI provides many pointers for Americans attempting to secure full health coverage."
"To begin with, Taiwan had a vigorous market-based health provision system, which has adapted itself, apparently very happily, to the new national service."
"The former KuoMintang government was an authoritarian social democracy, in the very limited sense that social provision was on the agenda. But corruption and capitalism were fully developed. The NHI was introduced in the early days of democracy, just as the KMT single-party system was being dismantled. It was a popular election issue.The provision of health care is not nationalized, despite a degree of information and coordination that, for example, the British system cannot match after spending billions on computerization."
"Rather, the NHI is a classic single payer scheme—the government runs a compulsory, mostly premium-financed insurance system, which negotiates a single payment schedule with the private and municipal or government-owned providers.On the face of it, the experience of the insured in Taiwan is certainly better than that of Americans dependent on the caprices of commercial health insurers."
" In 2005, polls showed a 72.5 percent satisfaction rate—and much of the dissatisfaction is with the cost, laughably small though it is by U.S. standards. When co-payments and premiums were increased in 2002, the satisfaction rate plummeted to 59.7 percent. "
"To put this in perspective, the premiums at the maximum are less than $20 (U.S.) per month (the annual per capita GDP is $16,500 U.S.).Taiwan has done this for proportionately, less than half the cost of the United States, with costs running at 6.2 percent of gross domestic product in 2005, compared with the following for other countries: United States, 15.2 percent; France, 10.1 percent; Canada, 9.9 percent; United Kingdom, 7.7 percent; Japan, 7.9 percent; South Korea, 5.2 percent (World Health Organization figures for 2003 published in 2006)."
"In absolute terms, the difference is even starker. In 2003, health spending per head in Taiwan was less than $800 per head of population compared to the U.S. level of approximately $5,500. In fact, by 2005, U.S. health care spending increased 6.9 percent to almost $2.0 trillion, or $6,697 per person, amounting to 16 percent of GDP."
" With an aging population demanding more and more innovative medical interventions, the NHI faces similar problems to the United States in terms of the escalation of demand (and thus of cost), but it has contained the growth of health care costs as a share of GDP while expanding coverage to a far higher proportion of hitherto uninsured people than in the United States."
http://dissentmagazine.org/article/?article=985
http://dissentmagazine.org/article/?article=985




