Wed, Feb 27, 2008 page2

• Health insurance reduces life-expectancy gap: study

  TOUGH JOB Although universal health care stopped a growing gap between rich and poor, society's privileged still outlive marginalized groups by more than a decade

  • By Angelica Oung / STAFF REPORTER
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  In the decade since it was launched, the National Health Insurance (NHI) has contributed to a modest reduction in the gap in life expectancy between the rich and poor sections of society, public health researchers found in a recent study.

  However, society's most financially privileged members still outlive the most marginalized groups by more than a decade on average, the study's results showed.

  In Taipei City, the average life expectancy is 79.62 years, while in Taitung County, the average life expectancy is only 69.59.

  The study, conducted by researcher Wen Chi-pang (溫啟邦) and others at the National Health Research Institute (NHRI), was published in the Feb. 19 edition of the Annals of Internal Medicine, a medical journal published by the American College of Physicians.

  To determine whether and in what ways the NHI has contributed to an overall healthier society since it was launched in 1995, Wen compared the average life expectancy of the populace as divided into 10 socio-economic groups. He found that those in the more marginalized sections of society had benefitted more from the creation of the NHI than those in more privileged groups in terms of increases in life expectancy.

  In the decade prior to the launch of the NHI, the life expectancy gap between the rich and the poor was steadily widening.

  The life expectancy gap between the most privileged and least privileged men was 8.37 years in 1984 and increased to 10.65 years in 1994. Since the institution of the NHI, the trend has reversed. By 2004, the gap had narrowed modestly to 10.03 years.

  The study found, however, that the NHI has not significantly accelerated the pace of overall lengthening of life expectancy, Wen said.

  In the decade before the NHI was created, the average life expectancy for men increased by 2.27 years, Wen's data indicated. During the decade after the NHI was instituted, the average male life expectancy increased by 2.39 years.

  Other factors contributed to the steadily increasing life expectancy, he said.

  "It's unrealistic to expect the NHI to improve the health of the nation dramatically by itself," Wen said.

  "In general, people overestimate the value of medical intervention," he said.

  However, further gains in life-expectancy will probably come from changes in lifestyle, Wen said.

  In an Annals of Internal Medicine editorial that referred to Wen's article, Karen Davis and Andrew Huang said that Taiwan's experience with national health insurance should send a clear message to US policymakers.

  "The improvement in life expectancy, although modest, for health class groups with the least healthy outcomes before national health insurance lends credence to the argument that the US should join other industrialized nations in ensuring universal health insurance coverage," the editorial said.
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