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.
As strategic tensions escalate across the vast Indo-Pacific region, Taiwan has emerged as more than a potential flashpoint. It is the fulcrum upon which the credibility of the evolving American-led strategy of integrated deterrence now rests. How the US and regional powers like Japan respond to Taiwan’s defense, and how credible the deterrent against Chinese aggression proves to be, will profoundly shape the Indo-Pacific security architecture for years to come. A successful defense of Taiwan through strengthened deterrence in the Indo-Pacific would enhance the credibility of the US-led alliance system and underpin America’s global preeminence, while a failure of integrated deterrence would
US President Donald Trump created some consternation in Taiwan last week when he told a news conference that a successful trade deal with China would help with “unification.” Although the People’s Republic of China has never ruled Taiwan, Trump’s language struck a raw nerve in Taiwan given his open siding with Russian President Vladimir Putin’s aggression seeking to “reunify” Ukraine and Russia. On earlier occasions, Trump has criticized Taiwan for “stealing” the US’ chip industry and for relying too much on the US for defense, ominously presaging a weakening of US support for Taiwan. However, further examination of Trump’s remarks in
It is being said every second day: The ongoing recall campaign in Taiwan — where citizens are trying to collect enough signatures to trigger re-elections for a number of Chinese Nationalist Party (KMT) legislators — is orchestrated by the Democratic Progressive Party (DPP), or even President William Lai (賴清德) himself. The KMT makes the claim, and foreign media and analysts repeat it. However, they never show any proof — because there is not any. It is alarming how easily academics, journalists and experts toss around claims that amount to accusing a democratic government of conspiracy — without a shred of evidence. These
China on May 23, 1951, imposed the so-called “17-Point Agreement” to formally annex Tibet. In March, China in its 18th White Paper misleadingly said it laid “firm foundations for the region’s human rights cause.” The agreement is invalid in international law, because it was signed under threat. Ngapo Ngawang Jigme, head of the Tibetan delegation sent to China for peace negotiations, was not authorized to sign the agreement on behalf of the Tibetan government and the delegation was made to sign it under duress. After seven decades, Tibet remains intact and there is global outpouring of sympathy for Tibetans. This realization
RSS