Chen Shih-Chung
Taiwan can help the World Health Organisation (WHO) achieve global universal health coverage by sharing its success in developing the world.
Taiwan’s National Health Insurance Programme (NHIP) is a global benchmark in universal coverage and offers valuable lessons in delivering high-quality, cost-effective medical care for all. Taiwan’s wealth of experience can help the WHO realise its top priority of achieving universal health care around the world specified by WHO Director-General Tedros Adhanom.
Taiwan would welcome the opportunity to share its expertise by participating in the 71st World Health Assembly, the decision-making body of the WHO, scheduled to be held in Geneva, Switzerland from May 21 to May 26, 2018.
Insurance for all
The NHIP is based on the principle of leaving no one behind. All citizens and foreign residents are enrolled.
Taiwan has consistently expanded insurance coverage over the years.
In 2013, all 60,000 prison inmates were added to the Programme.
A further measure broadening coverage was implemented in December 2017 when babies born in Taiwan to foreign residents, previously only eligible to join at six months old, were included at birth.
This demonstrates Taiwan’s respect for health care as a fundamental human right.
NHIP users can access a wide range of services spanning Western medicine, dental care and traditional Chinese treatments at affordable prices.
To ensure fairness, premiums are set as a proportion of an individual’s income.
This figure is currently 4.69% for employees, who pay 30% of this amount, with their employers contributing 60% and the government the remainder.
High Satisfaction Rate
In a Survey conducted by the Ministry of Health and Welfare last year, 85% of respondents expressed satisfaction with the NHIP.
“The NHIP Administration, under the Health and Welfare Ministry, is the single payer for all medical services. This arrangement ensures high levels of efficiency by significantly reducing administrative spending.
In 2017, these expenses accounted for 0.9% of total outlays.
This was the lowest in the world.
In addition to controlling costs, the NHIP has led to continuous improvements in public health through the regular introduction of cutting-edge medications and treatments.
Additional Incentives
Recent initiatives include the addition (in January 2017) of newly developed antiviral hepatitis C drugs for patients with advanced forms of the disease.
This move is expected to bolster public wellbeing, as the illness, a major cause of liver cancer, is estimated to affect up to 600,000 people, according to Taiwan nonprofit Liver Disease Prevention and Treatment Research Foundation.
In 2017, the National Health Insurance Administration (NHIA) allocated NT$2.4 billion (US$82 million) for the expensive, highly effective oral hepatitis C medications, providing the drugs to about 9300 people.
This year, a total of NT$4.25 billion (about US$145 million) has been earmarked to help additional 17,000 patients.
This is money well spent.
Dealing with the disease now will save a lot in the long term by preventing more serious health conditions.
Benefits of National Insurance
Since the launch of the NHIP, average life expectancy in Taiwan has risen from 74.5 to 80.2 years. This increase has drawn global recognition, with more than 50 foreign delegations visiting to learn about the Programme last year alone.
In the light of Taiwan’s rapidly aging population and the pressure this will place on medical care spending, the government is moving to ensure the long-term financial viability of the system.
A major step in this regard came in 2013 with the launch of the second-generation NHIP. Among other changes, the government boosted revenue by levying a 2% charge, lowered to 1.91% in 2016, on supplementary income such as bonuses and stock earnings.
This measure expanded the Programme’s premium base while making contributions more reflective of an individual’s full income.
New Reforms coming
Another round of reforms will be launched in the next three to four years with the aim of further boosting overall efficiency and ensuring fairness in premium contributions.
While no national health insurance programme in the world is perfect, Taiwan’s model has been a resounding success and can serve as a reference for other nations.
Through technical meetings at the WHA, Taiwan can learn from other countries and give back by sharing its health care expertise.
Chen Shih-Chung is Health and Welfare Minister of the Republic of China (Taiwan). Please read related story in this Section. (Staff Photo by Huang Chung-Hsin)
