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Evolution of Taiwan’s health care system

Published online by Cambridge University Press:  04 March 2010

Jui-Fen Rachel Lu*
Affiliation:
Department of Health Care Management, College of Management, Chang Gung University, Taiwan
Tung-Liang Chiang
Affiliation:
Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan
*
Correspondence to: Jui-fen Rachel Lu, Department of Health Care Management, College of Management, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, 33302 Taiwan. Email: [email protected]

Abstract

This study aims to present an overview of the evolutionary policy process in reforming the health care system in Taiwan, through dissecting the forces of knowledge, social-cultural context, economic resources and political system. We further identify factors, which had a significant impact on health care reform policies in Taiwan through illustrative policy examples. One of the most illuminating examples highlighted is the design and implementation of a single-payer National Health Insurance (NHI) program in 1995, after nearly five years of planning efforts (1988–1993) and a two-year legislative marathon. The NHI is one of the most popular social programs ever undertaken in the history of Taiwan, which greatly enhances financial protection against unexpected medical expenses and assures access to health services. Nonetheless, health care reform still has an unfinished agenda. Despite high satisfaction ratings, Taiwan’s health care system today is encountering mounting pressure for new reforms as a result of its rapidly aging population, economic stagnation, and imbalanced NHI checkbook. Although there may exist some heterogeneous system characteristics and challenges among different health care systems around the world, Taiwan’s experiences in reforming its health care system for the past few decades may provide valuable lessons for countries going through rapid economic and political transition.

Type
Articles
Copyright
Copyright © Cambridge University Press 2010

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