Mon, Jan 28, 2013 - Page 8 News List

An American’s insight into the NHS

By Adam Chimienti

First, let us remember that the National Health Insurance Program is rather efficacious in many of its most important goals. It provides excellent care and a freedom of choice for all those enrolled on how they heal themselves and which doctors to seek help from.

The system has among the lowest administration costs of any healthcare system in the world. We should remind ourselves that Taiwan’s system is more efficient than that of Austria, Germany, South Korea and Japan, according to a comparison by the WHO.

Second, Taiwan’s system cannot be privatized or scaled back without a major detriment to Taiwanese everywhere, rendering such changes unworkable.

There is no alternative (such as privatization or rolling back the vital and comprehensive services) that is socially acceptable.

The mostly private US system has myriad problems and these inefficiencies have resulted in more than 45,000 deaths in each of the past several years, according to a Harvard study by Steffie Woolhandler.

The incredibly expensive US system has more than 16 percent of the GDP going towards healthcare expenditure, compared to Taiwan’s 6.7 percent, but this astronomical amount still leaves about 50 million people without insurance.

Third, if Taiwan really wants to avert bankruptcy in its healthcare system, why not advance the cause of healthy living to cut down on illnesses?

Getting more aggressive on the enforcement of vehicle emissions and the curbing of industrial pollution, raising taxes on cigarettes (a pack costs five times more in New York than in Taipei) and other unhealthy lifestyle choices, would save the healthcare system much money in the long run.

Additionally, increased advocacy of vegetarian diets and meat-free days can all lead to a healthier nation.

These methods have all been attempted recently but maybe they should go further, while additional revenue through excise or luxury taxes can be earmarked for the National Health Insurance Program, benefiting everyone.

There is plenty of research to support the idea that raising the price of cigarettes, alcohol and other unhealthy lifestyle choices serves to decrease the amount of their use by people, leading to improved health, while also allowing the price of these items to be genuinely measured in terms of related social costs.

Yes, the costs of Taiwan’s system are rising steadily and funding is a serious issue, but if the system is meant to serve everyone’s health needs, then it has proven remarkably effective in doing so.

The program has also provided greater freedom of choice to Taiwanese (and even foreign workers).

Why not celebrate the system for what it has done right and continue to innovate and find new ways to reduce costs and fund aspects of the system that desperately need it, and commit to saving people’s lives?

This healthcare system, created in 1995, is internationally renowned and highly popular at home. Hold the National Health Insurance Program and a healthy country up for the rest of the world to see and show them Taiwanese innovation where it matters most: creating a fair and healthy society.

Adam Chimienti is a doctoral candidate at National Sun Yat-sen University’s Institute of China Asia Pacific Studies.

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