Healthcare system in taiwan
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Healthcare system in Taiwan
--National Health Insurance
References : www.nhi.gov.tw
+About TaiwanPopulation: 23,234,936 (world ranking:
51), with 10.9% of people over 65 years
Government: Multiparty democracy, last presidential election:2012
Geography: An island in eastern Asia, On the boundary of temperateness and
subtropical – TyphoonsOn the boundary of Filipino plate and
Eurasian plate - Earthquake
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History: Before 1895: Qing dynasty1895-1945 (end of WWII): Japanese
colonyAfter WWII: Nationalists ruling, with the
constitution found in 1947After 1949: Gradually democratized in a
peaceful pace
+Taiwanese health situation Life expectancy:
Total: 78.48 years Male: 75.66 years Female: 81.53 years
Infant mortality rate: 5.1 deaths/1,000 live births (world ranking: 179) Male: 5.38 deaths/1,000 live births Female: 4.8 deaths/ 1,000 live births
Total death rate: 7.12 deaths/1,000 population (world ranking: 128)
Prevalence of HIV/AIDS (2012): HIV infection: 24,309 AIDS: 9,367
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National Health Insurance (NHI)
Overview
Enrollment
Financing Insured Classification Premium Calculation Copayment System
Payment System
Future challenges
Overview
Started on March 1, 1995
Compulsory social health insurance program for all citizens from birth
Health Insurance IC Card
Second Generation National Health Insurance System
Enrollment
Taiwan (ROC) Citizens
Overseas ROC citizensstay in Taiwan for more than 3
months
Residents from Hong Kong, Macau, China and Other Foreignersstay in Taiwan for more than 6
months
Financing
Primarily funded by the premiums
Other revenues
Premium rates: reviewed and re-calculated every two
years
the premium rates has only been adjusted twice in the system's 15 years of existence4.25% (1995) → 4.55% (September
2002) → 5.17% (April 2010)
Financing - Insured Classification
Financing - Premium Calculation
Financing - Copayment System
Copayment Exemptions catastrophic illnesses living in remote mountain
areas or offshore islands child birth veterans and their
dependents low-income households children under the age of
three registered tuberculosis
patients who receive treatment at specified contracted hospitals
Patients being treated for occupational ailments who are covered by labor insurance
Payment System
Healthcare institutions signed contracts with the BNHI: 92.47%
Early years : “fee-for-service” → spiraling growth of medical cost
Pay-for-performance system (first introduced in 2001) breast cancer therapy, diabetes, asthma and
hypertension treatment
Global Budget Payment System
Taiwanese version of the Diagnosis Related Groups (Tw-DRGs) adopted 111 DRGs into practice for the first year
(2010) and would take 5 years to phase in the complete system (more than 500)
Who is benefited? Reference: Nicole Huang, Yiing-Jeng Chou, et al. The distribution of net benefits under the National Health Insurance programme in Taiwan. Health Policy and Planning 2007:22:49-59
Future challenges
Improving Access to Quality Care in Remote Regions
Expanding Resources to Care for Disadvantaged
Long-term Care Insurance
Making both Ends Meet
Taiwan’s public health challenges…Very low birth rate
8.81 births/ 1,000 population, world ranking: 211
Population growth rate: 0.171%, world ranking: 179
Food security: Cloudy agents contaminated by
plasticizerLeanness-enhancing drug
Thank you for your attention!