Princeton economist Uwe Reinhardt writes in this week's BMJ (subscription required for full text) about a humbling visit to see "Taiwan's highly efficient system of national health insurance."
Excerpts:
"Taiwan introduced its national health insurance system on 1 March 1995, after less than a decade of planning that went ahead in textbook fashion. After visiting the health systems of numerous other nations, Taiwan’s policy planners used the insights gained to develop what has been described as "a car made from many parts produced abroad but assembled in Taiwan." It took only 18 months for the plan to make its way through the legislative chambers in 1993-4. At the behest of Taiwan’s then president, Lee Teng-hui, it was implemented in less than a year. Overnight, health insurance coverage in Taiwan jumped from roughly 57% of the population before 1 March 1995 to virtually the entire population. For US policy makers and presidential contenders—who for half a century now have engaged in a perpetual "national conversation" on universal health insurance, only to see the number of uninsured people grow apace over the years—the speed of Taiwan’s move to a national health insurance system seems downright surreal. ...Posted by schwitz at January 11, 2008 10:31 AM | TrackBackIn the absence of national health insurance Taiwan would today probably have a highly stratified healthcare system, with top tier, US style care for the rich funded by private insurance, a social insurance system for the employed middle class with highly variable quality of care, and much less or nothing for millions of uninsured poorer citizens. ...
Loss of health insurance and fear of bankruptcy over medical bills is a growing fear among millions of Americans; it has not been in Taiwan since 1995. In a globalised economy that subjects Taiwan’s low skilled workers to ever fiercer foreign competition from low cost labour elsewhere in Asia, the safety net of the national health insurance system represents one of Taiwan’s major public assets."
The irony is that when the US health care system finally gets fixed it will be because business has to have this done so that it is possible to compete with Taiwan and other more enlightened countries.
Posted by: Bill Gleason at January 11, 2008 08:12 PMthe health care system in the US will never be "fixed" because there isn't anything political to be gained by it. good thing i left the US and now live in Taiwan, eh?
Posted by: MJ Klein at February 2, 2008 04:07 AM