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Health-care system earns praise

As the legislature and the Executive Yuan battle over a hike in national health insurance premiums, an international public-health expert said earlier this week that Taiwan's health system is worthy of praise.

Laura Morlock, professor and associate chair for health management programs in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health, called the system "very good."

Morlock is co-author of National Health Insurance in Taiwan: Analysis of Initial Effects From an International Perspective, which was published by the Executive Yuan in 1997.

"In comparison with other developed countries, the percentage of health expenditures in Taiwan's GDP is low," Morlock said during her visit to Taiwan this week.

According to the Bureau of National Health Insurance, Taiwan spent 5.77 percent of its GDP on health last year.

Morlock used the latest figures of OECD members to show that Taiwan's health expenditure as a percentage of GDP is lower than in most developed countries.

According to the data, most OECD countries spent 7 percent to 8 percent of GDP on health in 1998.

Taiwan's national health insurance program started in 1995. In 1998, Taiwan's health expenditures totalled only 5.33 percent of GDP, according to the Department of Health (DOH).

"Compared with the low percentage of GDP Taiwan spends on its health expenditures, the outcome of its national health care system is very good," Morlock said.

According to Morlock, child mortality, an important indicator of the quality of a country's health system, is low in Taiwan.

Having assisted the DOH in evaluating the impact of a national health insurance program, Morlock said a hike in health premiums and co-payment fees is the right thing to do.

According to Morlock, a health system works better with higher co-payment fees.

Morlock also responded to opposition lawmakers' demands that the hike be revoked.

According to the lawmakers, the hike should not be allowed until the bureau curbs the waste of medical resources in hospitals.

Opposition lawmakers believe the hike should be canceled because recent medical blunders have proven that the increase did not improve the medical system.

But Morlock said Taiwan is making do with fewer resources than in countries like the US.

"The number of hospital staff per bed is an indicator of the control of medical resources. In 1999, the number of hospital staff per bed was 4.6 in the US, whereas the number in Taiwan is only 1.5," Morlock said.

Morlock also suggested that the establishment of a voluntary, anonymous error-reporting system could help encourage hospitals to report medical errors.

The DOH could set up teams of medical specialists to review mistakes, Morlock said.
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