Taiwan Healthcare System
History of Taiwan
The history of Taiwan’s healthcare system started back in the year 1865 but ended up changing in the year 1995. For the most part, the changes were a combination of different countries healthcare systems and made a system that would be the best for Taiwan. The goal for Taiwan’s new healthcare system was to make sure every aspect was covered. Between the years 1988-1993, research for the new healthcare system occurred while in 1995 the two-year legislative was implemented. The history of Taiwan’s health care can be broken up into three main periods that helped shaped their system to what it is today.
Taiwan’s healthcare system truly started between the years 1865-1895 known as The Missionary Period. The movement to adopt western medicine was introduced by several western missionaries including Dr. James Maxwell, Dr. George Mackay and Dr. David Landsborough. These three doctors are significant to Taiwanese history because they opened the three major privately-run medical hospitals during this period helping to earn the respect from the local people.
After The Missionary Period came the medical development through the Japanese colonization of Taiwan during the years 1895-1945. The Japanese wanted to help impact the Taiwanese healthcare system because of the rampant epidemics, poor hygiene and climate conditions. These issues led to the change of the effective control of epidemics which helped create a firm foundation for Taiwan’s public health system.
Beginning in 1945 the Taiwanese took steps to progress the healthcare system. The damaged medical facilities during World War II and the tropical climate lead to the decision to focus more on the fundamental development of public health. Because of this situation, health stations increased all over to try and eliminate malaria, plague and cholera. This also led to the endorsement of every individual’s health, Planned Parenthood and the application of universal vaccination. At first this system was effective however as time progressed, the Taiwanese decided they needed to reform their system to provide for everyone and to assure equal access to the people.
The main issue in their healthcare system was that only a certain percentage of the population was covered which included civil servants, employees of large firms and farmers. In addition, 45% of the population was uninsured which made the President at the time reconsider how the healthcare system should be set up. The plan was to create a group of people who would research six different systems and implement them into one that would best suit the Taiwanese people. Starting in 1995, the healthcare system that would best fit the Taiwanese people would be a system called the National Health Insurance (NHI) system.
The NHI is a system that the Taiwanese government created in order to provide a stable healthcare system for all the people. Low income households, mentally disabled, indigenous citizens, and unemployed are eligible for government subsidization. After completing some research, the finance aspect was one of the major concerns for the people of Taiwan. Being that NHI is a single payer, premium based system, the government makes sure to provide everybody with some type of healthcare coverage. There are three different sources for premiums, which include the government, employers and the individual themselves. Since there healthcare system used to work on premiums, it was easier to adapt a premium based NHI because taxes were not making sufficient revenue to finance the system. Because they wanted to address the issue of unequal access of healthcare coverage, they made it compulsory to pay these premium fees.
Premiums are based on whether or not you are employed and what kind of career you have. These classifications can be broken up into six different categories that all have a variation of contribution