Taiwan Insight: Sustainable Universal Health Coverage: Lessons from Taiwan’s Single-Payer National Health Insurance – A Tribute to Uwe Reinhard

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In conclusion, Taiwan’s NHI has been successful in not only providing universal coverage and equitable access to health care services and goods for all Taiwanese, but also has done so with remarkably effective cost control. The large discrepancy in health spending between Taiwan and other rich countries, however, may also suggest that Taiwan could be underfunding its health system in certain areas. For example, in addition to the lack of a well-established long-term care program mentioned above and despite the urgent need for one, Taiwan has lower a doctor and nurse-population ratio compared to other rich countries. There have also been discussions of workforce shortages, which may adversely affect patient safety and quality of care. Taiwan is also slower in adopting new medical technology, including new cancer therapies, than many other health systems, which may explain the lower five-year survival and higher mortality rates for certain cancers (colorectal and cervical cancer) in Taiwan compared to many OECD countries. The NHIA’s low administrative budget hinders its ability to engage in more operations research to improve the NHI’s efficiency further, such as more policy and program innovations to improve care coordination, and development of its health technology assessment capabilities, etc. These are just a few areas in which Taiwan should spend more. Both Uwe Reinhardt and I have called for, in numerous previous writings, Taiwan to allocate 1-2% of its GDP to improve its health system’s overall efficiency, quality and patient safety.

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Sustainable Universal Health Coverage: Lessons from Taiwan’s Single-Payer National Health Insurance – A Tribute to Uwe Reinhardt

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