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APRIL 15, <strong>2018</strong><br />
18 Businesslink<br />
Taiwan makes its Health InsuranceProgramme aworld model<br />
Chen Shih-Chung<br />
Taiwan canhelpthe World<br />
HealthOrganisation<br />
(WHO) achieve global universal<br />
health coverageby<br />
sharing its success in developing<br />
the world.<br />
Taiwan’sNational Health<br />
InsuranceProgramme (NHIP)is<br />
aglobal benchmark in universal<br />
coverage and offers valuable<br />
lessons in deliveringhigh-quality,<br />
cost-effective medicalcare<br />
forall. Taiwan’swealth of experience<br />
can helpthe WHO realise<br />
its top priority of achieving universal<br />
health care around the<br />
world specified by WHO Director-<br />
GeneralTedrosAdhanom.<br />
Taiwan wouldwelcome the<br />
opportunitytoshareits expertise<br />
by participating in the 71st<br />
World HealthAssembly,the decision-making<br />
body of the WHO,<br />
scheduledtobeheldinGeneva,<br />
Switzerland fromMay 21 to May<br />
26,<strong>2018</strong>.<br />
Insurance forall<br />
TheNHIP is based on the principleofleavingnoone<br />
behind.All<br />
citizens and foreign residentsare<br />
enrolled.<br />
Taiwan has consistentlyexpanded<br />
insurancecoverage over<br />
the years.<br />
In 2013, all60,000 prison<br />
inmates were addedtothe<br />
Programme.<br />
Afurther measure broadening<br />
coverage wasimplemented<br />
in December 2017whenbabies<br />
born in Taiwan to foreignresidents,<br />
previously only eligible to<br />
join at sixmonths old,were included<br />
atbirth.<br />
ThisdemonstratesTaiwan’srespectfor<br />
health care as afundamental<br />
humanright.<br />
NHIP userscan access awide<br />
range of services spanning<br />
Western medicine, dental care<br />
and traditionalChinese treatments<br />
at affordable prices.<br />
To ensure fairness,premiums<br />
are setasaproportion of an individual’sincome.<br />
This figureiscurrently4.69%<br />
foremployees,who pay30% of<br />
this amount,withtheir employers<br />
contributing 60% andthe governmentthe<br />
remainder.<br />
HighSatisfaction Rate<br />
In aSurvey conducted by the<br />
MinistryofHealth and Welfare<br />
lastyear, 85%ofrespondents expressed<br />
satisfaction with the<br />
NHIP.<br />
“TheNHIP Administration,<br />
under the Health and Welfare<br />
Ministry, is the singlepayer for all<br />
medical services. This arrangement<br />
ensureshighlevels of efficiency<br />
by significantly reducing<br />
administrative spending.<br />
In 2017, these expensesaccounted<br />
for 0.9%oftotal outlays.<br />
This was thelowest in the<br />
world.<br />
In addition to controlling costs,<br />
the NHIP hasled to continuous<br />
improvements in public health<br />
through the regular introduction<br />
of cutting-edge medicationsand<br />
treatments.<br />
Additional Incentives<br />
Recent initiatives include the<br />
addition(in January2017)ofnewly<br />
developed antiviral hepatitis C<br />
drugs forpatientswith advanced<br />
forms of thedisease.<br />
Thismoveisexpected to bolster<br />
public wellbeing, as the illness,a<br />
major cause of liver cancer, is estimated<br />
to affect up to 600,000people,according<br />
to Taiwannonprofit<br />
Liver DiseasePrevention and<br />
TreatmentResearchFoundation.<br />
In 2017, the National Health<br />
InsuranceAdministration (NHIA)<br />
allocated NT$2.4billion(US$82<br />
million) forthe expensive, highly<br />
effective oral hepatitisCmedications,<br />
providing the drugs to about<br />
9300people.<br />
This year, atotal of NT$4.25billion<br />
(aboutUS$145 million) has<br />
beenearmarkedtohelp additional<br />
17,000 patients.<br />
Thisismoney wellspent.<br />
Dealing withthe diseasenow<br />
willsave alot inthe long term by<br />
preventing moreserious health<br />
conditions.<br />
Benefits of NationalInsurance<br />
Since thelaunch of the NHIP, averagelifeexpectancy<br />
in Taiwan<br />
has risen from 74.5 to 80.2years.<br />
This increasehas drawn global<br />
recognition, withmorethan<br />
50 foreign delegationsvisitingto<br />
learnabout theProgramme last<br />
yearalone.<br />
In the light of Taiwan’srapidly<br />
aging population and the pressure<br />
this will place on medicalcare<br />
spending, the governmentismovingtoensurethe<br />
long-term financial<br />
viability of the system.<br />
Amajor step inthisregard<br />
came in2013with the launch<br />
of the second-generation NHIP.<br />
Amongother changes, the governmentboostedrevenue<br />
by levyinga2%charge,lowered<br />
to 1.91%<br />
in 2016, on supplementary incomesuch<br />
as bonuses and stock<br />
earnings.<br />
This measure expanded the<br />
Programme’spremium base<br />
while making contributionsmore<br />
reflective of an individual’sfull<br />
income.<br />
NewReformscoming<br />
Anotherround of reformswill<br />
be launchedinthe nextthree to<br />
four yearswith the aim of further<br />
boostingoverall efficiencyand<br />
ensuring fairnessinpremium<br />
contributions.<br />
While no national health insurance<br />
programme in the world<br />
is perfect,Taiwan’s model has<br />
beenaresounding success and<br />
can serveasareference forother<br />
nations.<br />
Through technical meetings at<br />
the WHA, Taiwan canlearnfrom<br />
other countries andgive back by<br />
sharing its healthcareexpertise.<br />
Chen Shih-ChungisHealth<br />
andWelfareMinister of the<br />
Republic of China (Taiwan).<br />
Please read related story in this<br />
Section. (Staff Photo by Huang<br />
Chung-Hsin)
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