The implementation of National Health Insurance (NHI) in 1995 represented the realization of a primary goal in social and health policy in Taiwan. The ultimate goal of the program is universal coverage for all of Taiwan’s citizens. It is estimated that the NHI currently covers more than 98% of the population. In 2010, national health care expenditures in Taiwan totaled US$16.1 billion, representing 6.1% of the GDP. By 2012, these expenditures amounted to approximately 7% of the GDP. With the rapid growth in health insurance expenditures and a slow increase in premium collection, the NHI Bureau has had to take action to maintain a balance of income and expenditures to reduce deficits and to be financially self-sustaining.
Some of the actions being proposed are as follows:
- Adjusting the monthly premium to the salary of the beneficiaries—currently, the premium is a flat-rate of about 4.25% of beneficiaries’ reported salaries;
- increasing cost-sharing—patients currently share only 8%–9% of ambulatory care expenses and 5%–6% of hospitalization expenses, which are not enough to prevent patients from overusing medical services;
- eliminating the case-payment system;
- introducing managed care under a global budget; and
- providing consumers with their choices for insurance plans.
CMUH aims to always play a leadership role in educating the public about health, fostering informed health policies, and bringing real value to the health care system. Additionally, to reflect the changing health care system, we will move away from being only an acute-care hospital towards a system that delivers the full range of medical services covering a patient’s entire lifetime.
TMC hopes to combine many vital components, including those not usually considered part of an academic medical center, such as primary care and preventive health services (健康管理與預防醫學).