Region:
Asia
Category:
Society
Article type:
Approaches

Building on 20 years of success

Region:
Asia
Category:
Society
Article type:
Approaches
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Future challenges for the health system in Taiwan. More than 99 percent of the population is enrolled in the National Health Insurance System in Taiwan

The National Health Insurance System in Taiwan (NHI) has been internationally recognized for providing citizens with easy access to high quality medical services. More than 99 percent of the population is enrolled in the system, which involves about 93 percent of health care providers in the country.

The basic premiums, which are shared between the insured, companies and the government are calculated on the basis of the monthly salary and bonuses established scale. Those who are classified as lacking in resources may be subsidized premiums and co-payments or even the system itself to take charge of it, if necessary. As the NHI has achieved universal coverage at an affordable price, health care is no longer a financial burden on the public. These factors contribute to the system to have a satisfaction index of about 80 percent.

But this state of the health system was not reached in overnight. Since its launch in 1995, the NHI has had to face many financial problems. Although the system obtained positive figures for the first four years, increasing user demand resulted in a budget deficit, which stimulated the Government of the Republic of China (Taiwan) to implement fiscal and structural reforms throughout the system.

In 2013, the second generation NHI came under the supervision of the newly created Management NHI system under the Ministry of Health and Social Welfare. A key component of this change was the collection of an additional premium of two percent on capital gains and income from non-labor income, a move that contributed to a new financial strengthening of the NHI.

Another step that contributed to the success of the NHI was the adoption of the latest information technologies. These measures improved procedures and more dynamic services, paving the way towards greater organizational efficiency and reduced administrative costs.

The creation of the integrated circuit card is one of the most visible signs of technological innovation employed by the NHI. The card is used by all users of the system and acts as a link between the patient and health care provider, allowing the latter to rapidly and reliably access the latest medical reports from users way. This smart card is also a valuable tool for controlling the spread of highly contagious diseases, such as SARS (Severe Acute Respiratory Syndrome), allowing monitoring of the infected person and precise control of the dynamics of such outbreaks.

Given that time is essential when it comes to dealing with the medical problems and prescribing the right treatments with effective cost, NHI established in 2013 called PharmaCloud a cloud database records patient pharmaceutical accessible to healthcare professionals. This initiative has minimized the incidence of duplication of prescriptions and over-prescription, and the risk of harmful drug interactions.

Encouraged by the benefits of costs and effectiveness of PharmaCloud, the NHI was launched in 2014 "My Bank Health". It is a database that allows users to access in less than ten minutes to complete medical information last year. This includes records as hospitalization, medical expenses, outpatient visits and prescriptions. By having easy access to personal records, users are expected to become more aware of their own health and to develop a greater appreciation of the need to maintain a healthy lifestyle.

Equally significant is the use of an automated system for processing claims and refunds of expenses to hospitals. This has contributed to the cost of administering the NHI involving only 1.07 percent of total health spending, the lowest in the world. The significant database for claims, which can claim to be outstanding and have a system of internationally certified security information also allows the NHI analyze trends and generate statistics.

Haca Looking forward, declining birthrates and rapidly aging population are issues that are on the agenda. Taiwan is no exception to this global trend and its young population will be diminished obliged to assume a greater financial burden. In any estimate of future demand for health services, keep the aging factor into account. In 2014, the elderly population in Taiwan stood at 11.95 percent, and is projected to exceed 20 percent in 2025 and 40 percent in 2060.

Because Taiwan has a low birth rate and a high life expectancy, you will soon have the world's most rapidly aging population. This will result in a reduction in taxable income, causing even greater pressure on the financing of the NHI to cover the costs associated with caring for the growing number of elderly. Improving public health and slowing the rate of aging are, therefore, two of the most important challenges facing the NHI from the XXI century.

traslation: Belén Zapata