title: Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?
abstract: It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. We analyze the primary issues facing the NHI program with emphasis on financial and consumer behavioral aspects. Furthermore, we apply models from mainland China, South Korea and Singapore to discuss what Taiwan could learn from the systems employed by these countries to modify the NHI. Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Yen-Han
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Ting Fang Alvin
authors.initials: TFA
authors.lastname: Ang
authors.affiliation: College of Medicine, Pennsylvania State University-Hershey, Hershey, Pennsylvania, USA.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Chiang
authors.affiliation: Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Warren A
authors.initials: WA
authors.lastname: Kaplan
mesh_terms: D002681:China; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000458:organization & administration; D056910:Republic of Korea; D012846:Singapore; D012959:Socioeconomic Factors; D013624:Taiwan
keywords: National Health Insurance; Taiwan; health service; healthcare controversies; healthcare system