Introduction to Taiwan National Health Insurance (NHI)

Hi ! My name is Chung-Hsue n Wu. I am an associate professor in the school pharmacy at the Taipei medical university. Today I am very happy to introduce you Taiwan National Health Insurance System. Most of today’s presentation was from the National Health Insurance Administration. Under the department of the health and welfare of our government and also other contents of today’s presentation was from the National Health Insurance 2017 annual report. So let’s begin with today’s presentation. There will be four major parts including in our presentation today.

There are the “Introduction of Taiwan National Health Insurance”, “National Health Insurance framework and financing”, The third part is the strength and the weakness of the NHI”, and the final part is the “Future challenge and E-services.” So, let’s begin with the first part! This is an overview of Taiwan’s national health insurance program which was launched first in March 1st 1995 to provide health care insurance for all residents living in Taiwan. Here is an overview of Taiwan. There are over 23 million people living in Taiwan about 12 percent of the population is over the age of 65. As of 2015 GDP per capita exceeded 22 thousands (22,294) US dollars and the total health expenditure was about 6.2% of the GDP.

Life expectancy for female is about 83 years old and for males is about 76 years old. In addition, The leading causes of death in 2015 is cancer, cardiovascular iseases, and diabetes. Before the implementation of national health insurance. Taiwan had 13 social insurances such as labor insurance, government employee insurance and farmer insurance which provided composite social security benefits including health care coverage to specific groups. However, only 59% of the population was covered by these insurance plans in 1994. Since national health insurance was established. All previous plans were consolidated into the national health insurance to provide nationwide protection to Taiwan citizens and international residents.

In order to improve the quality of health care and ensure the soundness of finance and encourage public participation. The second generation of the program began in January 1st,2013. NHIA Organizations The National Health Insurance dministration was previously known as the “Bureau of National Health Insurance” under the Executive Yuan and defined as a “financial and insurance public enterprise.” When founded in 1995, the BNHI merged three existing health insurance program – labor insurance, farmers’ health insurance and government employee insurance– that covered only around 50 percent of the population at the time expanded into a comprehensive social insurance program that offered universal coverage based on the principles of sustainability and caring for the disadvantage.

The BNHI was repositioned in 2010 as an “administrative agency” and renamed as the NHIA in 2013 as a part of the government reorganization program. It has ultimately emerged as a state-run national health insurance agency based on a single-payer model. Taiwan’s National Health Insurance system is a social insurance health program organized by the government under the Ministry of Health and Welfare. The ministry’s National Health Insurance Committee helps plans and monitor NHI-related tasks. The NHIA is responsible for managing health insurance affair, medical quality, research and development, manpower training and information on the health care system. It is operations are funded out of the central government budget.

Taiwan’s health care system is dominated by the private sector, hospitals adopt a closed staff model and physician are primarily salaried by hospitals. There’s no gate keeper system to screen patients. Patients can go to any clinic or directly visit the hospital without a referral. The volume of hospital outpatient services is very high as a consequence. However, health care is usually provided in a timely way and waiting time is pretty slim. Here are some main characteristic of Taiwan’s health insurance program NHI is a compulsory program and all residents must enroll. The NHI administration is the only agency authorized to administer to the program. It collects premiums from the insured, reimburses medical payments to health care providers.

The health care coverage is very comprehensive and people need to pay a copayment when seeking health care. Although it is voluntarily for health care provider to participate in the program, about 93 percent of health care provider nationwide have contracted with National Health Insurance. Providers are reimbursed according to payment programs under the global budget payment systems. The premium subsidies and copayment waiver for the disadvantaged have been granted through different project.