The per capita healthcare spending programme implemented in country's Xiulin township on a trial basis has been successful. The programme pilot initiated by the National Health Insurance Administration will now be expanded into more areas of Hualien and Taitung region.
President Lai Ching-te has affirmed that the National Health Insurance Administration’s per capita healthcare spending trial in Xiulin township was successful and the health ministry plans to expand the pilot programme into more of the Hualien and Taitung area.
Taiwan currently employs a pay-per-volume healthcare system, also known as fee-for-service, where providers are reimbursed for each individual service they provide. A per capita healthcare payment system, however, reserves a fixed amount for medical services per year for each person registered.
Taiwan College of Healthcare executive president Hung Tzu-jen has however said that the per capita system will restrict people's access to medical treatment. It also has some inherent risks including scenarios such as medical institutions hindering medical treatment and delaying referral time to collect money, or small clinics shutting down due to lower payouts.
He said ideally, a per capita healthcare payment system could reduce unnecessary use of the government budget, but the transition must be undertaken with care.
He said monitoring protocols for cure rates, treatment waiting time and also improvement in overall public health indicators must be established to make the new scheme successful if implemented.
The National Health Insurance System offers a coverage rate of 98-99%, offering benefits for a wide range of medical conditions, from the common cold to organ transplants and cancer treatments. The country also leads the world in disease coverage and, according to global database Numbeo, has ranked first in the Health Care Index for six consecutive years.
However, from time-to-time experts have also raised concerns about Taiwan’s medical sector, particularly the shortage of doctors in specialties such as internal medicine, surgery, obstetrics, and paediatrics. If this trend continues it could have serious repercussions for public healthcare.
Rapid ageing of the country’s population and declining birth rates are also a warning that an ageing society will increase healthcare expenditures, while a shrinking workforce could undermine the system’s financial sustainability, leading to intergenerational inequities. These demographic trends could make the country’s public health insurance system unsustainable.