Some brief about Taiwanese National Health Insurance!!

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Healthcare system in Taiwan
--National Health Insurance
References : www.nhi.gov.tw

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About Taiwan
 Population:
23,234,936 (world ranking: 51),
with 10.9% of people over 65 years
 Government: Multiparty democracy, last
presidential election:2012
 Geography:
 An island in eastern Asia,
 On the boundary of temperateness and
subtropical – Typhoons
 On the boundary of Filipino plate and Eurasian
plate - Earthquake

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 History:
 Before 1895: Qing dynasty
 1895-1945 (end of WWII): Japanese colony
 After WWII: Nationalists ruling, with the
constitution found in 1947
 After 1949: Gradually democratized in a
peaceful pace

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Taiwanese health situation
 Life expectancy:
 Total: 78.48 years
 Male: 75.66 years
 Female: 81.53 years
 Infant mortality rate: 5.1 deaths/1,000 live births (world
ranking: 179)
 Male: 5.38 deaths/1,000 live births
 Female: 4.8 deaths/ 1,000 live births
 Total death rate: 7.12 deaths/1,000 population (world
ranking: 128)
 Prevalence of HIV/AIDS (2012):
 HIV infection: 24,309
 AIDS: 9,367

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6. National Health Insurance (NHI)
 Overview
 Enrollment
 Financing
 InsuredClassification
 Premium Calculation
 Copayment System
 Payment System
 Future challenges

7. Overview
Started on March 1, 1995
Compulsory social health insurance
program for all citizens from birth
Health Insurance IC Card
Second Generation National Health
Insurance System

8. Enrollment
Taiwan (ROC) Citizens
Overseas ROC citizens
 stay in Taiwan for more than 3 months
Residents from Hong Kong, Macau,
China and Other Foreigners
 stay in Taiwan for more than 6 months

9. Financing
Primarily funded by the premiums
Other revenues
Premium rates:
 reviewed and re-calculated every two
years
the premium rates has only been
adjusted twice in the system's 15
years of existence
 4.25% (1995) → 4.55% (September 2002)
→ 5.17% (April 2010)

10. Financing - Insured Classification

11. Financing - Premium Calculation

13. Financing - Copayment System

14.  Copayment Exemptions
 catastrophic illnesses
 living in remote mountain
areas or offshore islands
 child birth
 veterans and their dependents
 low-income households
 children under the age of three
 registered tuberculosis
patients who receive treatment
at specified contracted
hospitals
 Patients being treated for
occupational ailments who are
covered by labor insurance

15. Payment System
 Healthcare institutions signed contracts with the BNHI:
92.47%
 Early years : “fee-for-service”
→ spiraling growth of medical cost
 Pay-for-performance system (first introduced in 2001)
 breast cancer therapy, diabetes, asthma and hypertension
treatment
 Global Budget Payment System
 Taiwanese version of the Diagnosis Related Groups (Tw-
DRGs)
 adopted 111 DRGs into practice for the first year (2010)
and would take 5 years to phase in the complete system
(more than 500)

16. Who is benefited? Reference: Nicole Huang, Yiing-Jeng Chou,
et al. The distribution of net benefits under
the National Health Insurance programme in
Taiwan. Health Policy and Planning
2007:22:49-59

17. Future challenges
Improving Access to Quality Care in
Remote Regions
Expanding Resources to Care for
Disadvantaged
Long-term Care Insurance
Making both Ends Meet

18. Taiwan’s public health challenges…
 Very low birth rate
 8.81 births/ 1,000 population, world ranking:
211
 Population growth rate: 0.171%, world ranking:
179
 Food security:
 Cloudyagents contaminated by plasticizer
 Leanness-enhancing drug

19. Thank you for your attention!