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