Healthcare in Taiwan is administered by the Ministry of Health and Welfare of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totaled US$752 in 2000. Health expenditures constituted 5.8 percent of the gross domestic product (GDP) in 2001 (or US$951 in 2009); 64.9 percent of the expenditures were from public funds. Overall life expectancy in 2019 was averaged at 81 years.
Recent major health issues include the SARS crisis in 2003, though the island was later declared safe by the World Health Organization (WHO).
National Health Insurance
The current healthcare system in Taiwan, known as National Health Insurance (NHI, ), was instituted in 1995. NHI is a single-payer compulsory social insurance plan that centralizes the disbursement of healthcare funds. The system promises equal access to healthcare for all citizens, and the population coverage had reached 99% by the end of 2004. NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for public and private providers. Most health providers operate in the private sector and form a competitive market on the health delivery side. However, many healthcare providers took advantage of the system by offering unnecessary services to a larger number of patients and then billing the government. In the face of increasing loss and the need for cost containment, NHI changed the payment system from fee-for-service to a global budget, a kind of prospective payment system, in 2002.
The implementation of universal healthcare created fewer health disparities for lower-income citizens in Taiwan. Additionally, life expectancy increased more in health class groups that had higher mortality rates before national health insurance was introduced. Life expectancy in Taiwan is about 80 years old as of 2018. Infant mortality rate is low and only 4 deaths for 1,000 live births as well as fertility rates are very high and stable. Taiwan has shifted its approach to allow its country to set structures and functions for other countries to follow. Although there are many different people to tend to including the disabled, Taiwan has catered to its best ability and also supported more than 23.4 million citizens to provide this universal healthcare.
History
Modern medicine only reached Taiwan after the Japanese invasion in 1895. Disease was one of the biggest challenges faced by the Japanese in their early years on Taiwan, a Japanese Prince who was part of the invasion force died of malaria. The Japanese introduced western medicine and modern sanitation practices. The introduction of water purification plants reduced the spread of cholera and other diseases. Communicable disease was a major issue, a plague outbreak lasted from 1898 to 1918. Malaria was reduced through the draining of wetlands and the clearing of bamboo forests.
Following the retreat of the KMT to Taiwan healthcare consisted of a mix of Japanese era institutions and military/veterans institutions which the KMT brought with them along with 1.5 million troops and civilians. Healthcare continued to be almost entirely a government concern until the 1970s when a number of Taiwan’s leading industrial groups opened hospitals.
In July 2013, the Department of Health was restructured as the Ministry of Health and Welfare.
Healthcare reform
Taiwan started its health reform in the 1980s after experiencing two decades of economic growth.
In 1987, the government did away with the martial law that mobilized the governmental departments. The government set up a planning commission and studied other countries' healthcare systems. Taiwan looked at more than ten countries and combined their best qualities to form their own unique system. Healthcare bills were fast-tracked through the Legislative Yuan between 1993 and 1994.