Taiwan's 1995 health care reform

Under considerable domestic political pressure, the Taiwan government inaugurated a compulsory universal health insurance scheme on 1 March 1995. This new scheme is financed mainly by payroll tax and provides comprehensive health care benefits with a moderate cost sharing. In order to gain efficienc...

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Bibliographic Details
Published in:Health policy (Amsterdam) 1997-03, Vol.39 (3), p.225-239
Main Author: Chiang, Tung-liang
Format: Article
Language:English
Subjects:
Biological and medical sciences
Comprehensive Health Care - economics
Comprehensive Health Care - organization & administration
Comprehensive Health Care - utilization
Efficiency, Organizational
Fee Schedules
Finance
Financial Management
General aspects
Health administration
Health care
Health Care Costs
Health Care Rationing
Health Care Reform - legislation & jurisprudence
Health Care Reform - organization & administration
Health care reform, Taiwan
Health Expenditures - trends
Health insurance
Health policy
Health services
Health Services Accessibility
Health systems. Social services
Macro-efficiency
Medical sciences
Medical service, State
Microefficiency
Miscellaneous
National Health Programs - economics
National Health Programs - organization & administration
Public health. Hygiene
Public health. Hygiene-occupational medicine
Reform
Social Justice
Taiwan
Universal Coverage - economics
Universal Coverage - legislation & jurisprudence
Universal Coverage - organization & administration
Universal health insurance
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Summary:Under considerable domestic political pressure, the Taiwan government inaugurated a compulsory universal health insurance scheme on 1 March 1995. This new scheme is financed mainly by payroll tax and provides comprehensive health care benefits with a moderate cost sharing. In order to gain efficiency in delivering health services, the scheme enters contracts with health care providers and has been developing a prospective payment system. Mean-while, the scheme uses a uniform fee schedule and makes all payments through a public single-payer system to control health care costs. By the end of the inaugural year, the scheme covered 92% of the population and the utilization pattern of the newly insured became close to that of the previously insured. However, there is the beginning of a financial crisis because the payments of the scheme are rapidly increasing and expect to exceed the premiums in the coming year. Besides, the scheme did not bring in the efficient use of health care resources and probably caused it to worsen. Taiwan's health care reform has an unfinished agenda.
ISSN:0168-8510
1872-6054
DOI:10.1016/S0168-8510(96)00877-9