With all the brickbats that are frequently thrown at the National Health Insurance (NHI) system, and the even more frequent warnings of a financial implosion, outsiders’ perspective brought Taiwan and the NHI some welcome praise this week.
HSBC’s latest Expat Explorer survey, conducted by YouGov, polled nearly 9,300 expatriates around the world through an online questionnaire in April and May about quality of life, finances and raising families.
According to the Expat Explorer Web site, Taiwan’s healthcare system was ranked as one of the best in the world, far outranking other nations in terms of affordability and quality. Almost two-thirds of the respondents (64 percent) said they enjoy a high quality of healthcare in Taiwan, compared with the global average of 38 percent.
A chart that compared the availability versus the quality of healthcare showed that Taiwan was far and away above the four other countries in the affordable, high-quality sector — the UK, Thailand, Japan and Saudi Arabia — while the US, Ireland, New Zealand and Brazil were at the other end of the spectrum, at the bottom of the expensive, low-quality sector, and Switzerland, Singapore and the Netherlands offered the most expensive, yet high-quality care.
Respondents also praised the ease of getting enrolled in the NHI system, with 69 percent of expatriates in Taiwan saying that organizing health insurance was relatively easy, compared with a global average of 55 percent who said the same.
Yes, there are problems with Taiwan’s single-payer system, including the need to control costs amid the development of more sophisticated — and expensive — treatments; how to resolve perennial workforce shortages, especially among nursing personnel, that are driving many skilled, overworked people out of the industry; the dichotomies caused by the government’s depiction of the NHI both as a form of social welfare and social insurance, and smoothing out the hiccups from the shift from a fee-for-service to a diagnosis-related group system, the second stage of which began in July.
The Ministry of Health and Welfare remains bogged down in paperwork and endless talk when it comes to seeking ways to fix long-standing problems with the program. For example, at the beginning of last month it put forward 36 suggestions made by the seven-member second-generation NHI program review team. However, the team submitted the suggestions in April, after holding eight plenary and 16 group meetings over the past year, and yet, according to critics, several of the proposals were simply a rehashing of the earliest version of the second-generation NHI program design guidebook.
Endless meetings with little to show for them are a benefit to no one.
Nearly two decades since the NHI system was introduced, it remains a good example of what can be accomplished: universal, comprehensive health insurance coverage under a single-payer system with easy accessibility to low-cost healthcare (with some exceptions in rural areas and outlying islands), short waiting times, a large degree of patient choice for providers and the gradual rollout of a centralized electronic medical record system that allows doctors in one hospital or clinic access to all of a patients’ medical records from that institution.
The nation spends nearly 7 percent of GDP on healthcare. Compare that to the US, which spends about 18 percent of its GDP on healthcare and yet has a system that benefits primarily the wealthy, and critics are trying to rollback even the limited achievements of Obamacare.
The NHI can be improved, but Taiwan and Taiwanese can be justly proud of what has been achieved so far.
Recently, China launched another diplomatic offensive against Taiwan, improperly linking its “one China principle” with UN General Assembly Resolution 2758 to constrain Taiwan’s diplomatic space. After Taiwan’s presidential election on Jan. 13, China persuaded Nauru to sever diplomatic ties with Taiwan. Nauru cited Resolution 2758 in its declaration of the diplomatic break. Subsequently, during the WHO Executive Board meeting that month, Beijing rallied countries including Venezuela, Zimbabwe, Belarus, Egypt, Nicaragua, Sri Lanka, Laos, Russia, Syria and Pakistan to reiterate the “one China principle” in their statements, and assert that “Resolution 2758 has settled the status of Taiwan” to hinder Taiwan’s
Singaporean Prime Minister Lee Hsien Loong’s (李顯龍) decision to step down after 19 years and hand power to his deputy, Lawrence Wong (黃循財), on May 15 was expected — though, perhaps, not so soon. Most political analysts had been eyeing an end-of-year handover, to ensure more time for Wong to study and shadow the role, ahead of general elections that must be called by November next year. Wong — who is currently both deputy prime minister and minister of finance — would need a combination of fresh ideas, wisdom and experience as he writes the nation’s next chapter. The world that
The past few months have seen tremendous strides in India’s journey to develop a vibrant semiconductor and electronics ecosystem. The nation’s established prowess in information technology (IT) has earned it much-needed revenue and prestige across the globe. Now, through the convergence of engineering talent, supportive government policies, an expanding market and technologically adaptive entrepreneurship, India is striving to become part of global electronics and semiconductor supply chains. Indian Prime Minister Narendra Modi’s Vision of “Make in India” and “Design in India” has been the guiding force behind the government’s incentive schemes that span skilling, design, fabrication, assembly, testing and packaging, and
Can US dialogue and cooperation with the communist dictatorship in Beijing help avert a Taiwan Strait crisis? Or is US President Joe Biden playing into Chinese President Xi Jinping’s (習近平) hands? With America preoccupied with the wars in Europe and the Middle East, Biden is seeking better relations with Xi’s regime. The goal is to responsibly manage US-China competition and prevent unintended conflict, thereby hoping to create greater space for the two countries to work together in areas where their interests align. The existing wars have already stretched US military resources thin, and the last thing Biden wants is yet another war.