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Taiwan can help meet health-for-all targets

  • Publish Date:2018-05-22

 Posted on 16 May 2018

Chen Shih-Chung

THE World Health Organisation (WHO) has urged member states to achieve universal health coverage by 2030. Although not a WHO member, Taiwan has offered universal health coverage to its 23 million citizens since 1995.

Taiwan launched its National Health Insurance (NHI) initiative by integrating medical programmes for labourers, farmers, and government employees, which covered only half the population. This was expanded to provide equal coverage to all citizens from birth. All foreigners who legally work or reside in Taiwan are also covered.

The NHI is a public programme run by the government based on a single-payer model. Life expectancy in Taiwan has increased to levels seen in key OECD countries, with women living on average to 83.4 years old, and men to 76.8. Yet healthcare costs are far lower in Taiwan than in most highly developed countries in Europe and North America, at US$1,430 per capita per year, representing just 6.3% of GDP in 2016. Administrative costs run at less than 1% of the total and public satisfaction remains high, at 85.8% in 2017.

Taiwan's health system has undergone reforms to ensure its sustainability. Implementing the Global Budget Payment on top of Fee-For-Service reimbursement method effectively reduced annual medical expenditure growth from 12% to 5% since 2003. And the way premiums are collected has also changed from being purely payroll-based, to including supplementary premiums based on capital gains, which has created a surplus for the National Health Insurance Fund.

The NHI's information system has migrated to the cloud, making it easier for hospitals, clinics, and doctors to access medical information. We encourage hospitals to upload computed tomography and magnetic resonance imaging scans so they can be retrieved for consultations. A personalised cloud-based service, My Health Bank, enables patients to check their records.

The government has adopted a wide range of measures to reduce health inequalities affecting disadvantaged groups. We have premium subsidies for low-income and near-poor households, as well as the unemployed. We have also improved the provision of services in areas with limited healthcare resources, and implemented an Integrated Delivery System (IDS) in remote areas. We also raised subsidies on preventive healthcare services for indigenous populations.

It is impossible for countries to overcome healthcare challenges on their own. It is only through interdisciplinary and international cooperation that we can build a global health system that consistently and cost-effectively meets the healthcare needs of people worldwide and bring to fruition the WHO's ultimate goal of health for all.

Taiwan has a great deal of experience in building and maintaining a universal health insurance system. We believe that Taiwan's healthcare system can serve as a model for other countries. It has a constructive role to play in creating a robust global health network, and the best way is through taking part in the World Health Assembly (WHA) and WHO.

It is regrettable that political obstruction led to Taiwan being denied an invitation to the 70th WHA as an observer last year. The WHO not only failed to abide by its constitution, but also ignored widespread calls for Taiwan's inclusion. Yet, Taiwan remains committed to helping enhance regional and global disease prevention networks, and assisting other countries in overcoming their healthcare challenges.

Taiwan seeks to take part in the 71st WHA this year as an observer.

Dr Chen Shih-Chung is Taiwan's minister of health and welfare.