Taiwanese health programme rejects China

Sonya Bryskine

Chinese hospitals are unlikely to be included in Taiwan』s national healthcare programme, said Taiwan』s health minister.

Yang Chih-liang refuted an erroneous report in The Liberty Times last week, saying it was 「sheer nonsense」 to mention that the inclusion of the hospital rebates be included in the upcoming meeting between China』s and Taiwan』s health ministers.

According to Yang, adding Chinese hospitals into Taiwan』s health insurance system has been an ongoing debate and has been under discussion ever since Taiwan』s National Health Insurance was established in 1995.

The main supporters of the inclusion are Taiwanese business people, frequently travelling to China. Currently if they receive treatment on the Mainland, they need to register their medical bills with the local authorities, before filing for compensation in Taiwan. The process is long and often costly.

By including the Chinese hospitals into Taiwan』s National scheme, patients could immediately claim the costs of the treatment and medications.

However, some lawmakers oppose the merge, saying it will only give Chinese hospitals more room for profiting.

China』s health system has struggled to develop an efficient and cost-effective programme that can cover the 1.3 billion population.

Currently the main problem in China is that doctors are paid very little, and so they try to make up costs by over-prescribing medications.

For each prescription, they get a fixed share of the cost – 20 percent. But that means to increase their income by $1000, they must prescribe $5000 of drugs. Many of the prescriptions are completely unnecessary.

Taiwan』s healthcare is one of the best.

However, Taiwan has worked for over a decade on developing and implementing an impressive health care programme.

The key lies in what』s called a 「single-payer」 insurance scheme, which is similar to Canada』s programme. Single-payer means only the government reimburses doctors and hospitals for the costs of health care.

While this limits the free competition in the market, it has worked effectively to generate health insurance coverage for 99 per cent of Taiwan』s 23 million population. By comparison in the US more than 45 million people remain uninsured.

The scheme has also managed to minimize costs. Taiwan spends just 6.5 percent of its gross domestic product on health care. The US spends more than 15 percent.

According to the Government 2009 National Health Insurance report, Taiwan』s plan covers both Western and Chinese medicine, including acupuncture. It pays for abortions, but only in cases of sexual assault. And it covers 60 days of end-of-life care, either at home or in a hospice or hospital.

Revenues from Taiwan』s plan come from a combination of individual payroll deductions, employer and government contributions, with additional funds coming from a 「sin tax」 on cigarette sales.

However, the scheme is no totally problem-free. It has been in deficit since 2007 and the Government was forced to borrow money from the banks to fund it.

It has also seen a problem of being 「over-used」, especially at the more popular hospital facilities, where people believe they will be receiving better care.

The Global Post reports of the Taipei University Hospital being overcrowded, while the smaller rural clinics suffering from being under-used.

However, despite some problems Taiwan has been considered to have one of the world』s best health care programmes.

The quality and costs of the health care are said to be so highly praised, that Taiwanese migrants find it cheaper to travel back home, than seek treatment in the US, according to one report in the Global Post.