Development And Comments On National Health Insurance In Taiwan

The research object of the thesis is the national health insurance (NHI) in Taiwan .The thesis summarizes and compares the reform process of health insurance in Taiwan from the ancient regime to national health insurance, and form the first generation to the second. The superiority of the first generation national health insurance to the second one manifests in three aspects : universality,coerciveness and calculation method of premium . universality means put all the people into the health care system so as to protects the right of life and health of every citizen equally , which is the essence difference between the national health insurance and the ancient regime . Coerciveness means forcing the people participate insurance . The right of coerciveness is that the unpredictability of the future could make anyone poor due to disease . In order to avoid this phenomenon, the government have to protect all the people by forcing them participate the insurance . I the aspect of computation of premium , NHI designs different levels for premium according to salary . Although make salary the only standard is not reasonable enough but it shows the concept that high paying people pay much premium while low paying people pay less so as to protect vulnerable groups . The part share and referral system play an active part in limiting the waste of medical resource.Compared with the ancient regime NHI is advanced in legitimacy and justice, but it also has some problems . Since 2001 the Taiwan authorities have been planning the reform of health insurance. During the pass 10 years the draft of the second generation NHI has been discussed and amended many times and finally the bill of second generation NHI came out. The highlights of the NHI reform is as follows: 1. Add dividend and big bonus as supplement premium ; 2. lower the stander of low income households in order to take care of economic disadvantage groups . 3. Limit the waste of medical resource .4. Black hole of medicine prices is prevented by law.5. NHI card would not be frozen for that who cannot afford and who is suffering from domestic violence. The above five aspects indicate that , the second generation NHI is from the practice experience of the first generation , it amends some unreasonable regulations in order to higher the degree of protection to the disadvantage and the institution is attending to more and more justice . While the reform on NHI is not complete and there are two drawbacks comparedwith the second generation NHI draft: 1. the draft abolished the classification by occupation while the bill follows the original classification approach except adding the prisoner into the NHI.2. The drafts set the household income as premium calculation basis while the bill still sets individual salary as a basis and only add dividend and big bonus as supplement premium. The above two are expected to be amended in the future reform.Any institution would be restricted by the natural environment and social economy development level, and it has to compromise to reality. So when commenting an institution we should focus on the trend of self-correcting but only pay attention to the result. Though the self-correcting trend of the NHI in Taiwan we could find that it holds legitimacy and justice dynamically and the development direction is certainly a worthy one.