"Creating a New Chapter for Taiwan's Smart Healthcare Series 4": NHI Reform Is Imminent; Four Aspects Should Be Addressed

“Building a New Chapter for Smart Healthcare in Taiwan Series 4”

Health Insurance Reform Imminent, Should Focus on Four Aspects

Since its implementation in 1995, Taiwan’s National Health Insurance (NHI) system has long been recognized and supported by the general public for its comprehensive coverage and relatively low out-of-pocket costs.

According to data provided by the government, public satisfaction with the NHI remains above 70%, affirming its stable position in the hearts of the people. The convenience and peace of mind brought by the NHI have thus formed a social consensus, regarded by the public as an indispensable social welfare.

Subtitle: Public Supports Rate Adjustment, More Concerned with Service and Value

However, public praise for the NHI system is not without contention. The adjustment of NHI premium rates in 2021, even amidst the severe global pandemic, proceeded smoothly with public opinion rising rather than falling. This indicates that public support for the NHI in Taiwan is not based on whether rates increase, but rather on what specific services and value the NHI can provide.

Delving into the deeper reasons, partly, the NHI quickly alleviated the pressure on the public from bearing high medical expenses in a short period, resolving the predicament of "being unable to afford medical care." At the same time, NHI payments cover diagnoses and treatments for various diseases. Even as drug costs continue to rise, the NHI, despite financial constraints, continues to provide relatively stable medical payments, ensuring that people do not shrink back from illness due to financial pressure.

At the same time, the public also has expectations and concerns regarding the investment and allocation of medical resources. Therefore, in the context of limited resources, how to maintain the sustainable development of the NHI and balance the needs of people of different age groups and socioeconomic backgrounds will be a major challenge for the NHI in the future. Thus, exploring and constructing an NHI system that is both efficient and equitable will be an important task for promoting shared health benefits for all citizens.

Subtitle: Learning from Other Countries for Applicable Practices Based on Taiwan's Actual Situation

Facing future NHI challenges, Taiwan has a clear direction: to expand NHI services from mere medical treatment to four major areas: preventive medicine and healthcare, the promotion of home healthcare programs, the development of precision medicine, and the digital upgrade of NHI. For example, the "Da Jia Yi Project" (Everyone's Doctor Project) aims to integrate NHI and medical care seamlessly, focusing more on prevention rather than just treatment, thereby reducing potentially continuously rising medical expenditures in the future.

On an international level, many countries' health insurance systems also face similar challenges and are seeking viable reform strategies. For instance, Germany actively promotes prevention programs and health promotion activities within its health insurance system. The German government invests resources to reduce the incidence of diseases among the public, especially in preventive medicine for the elderly. Additionally, German health insurance encourages public participation in health promotion activities by providing payments, viewing individual health as a shared responsibility.

On the other hand, the application of digitalization and technology plays an increasingly important role in health insurance reforms worldwide. Sweden is an example of successfully using digital technology to improve medical services. Through data analysis and extensive use of electronic health records, Sweden can more effectively allocate medical resources, track patients' health status, and enhance the quality and efficiency of medical services.

Looking at Singapore's example, its exploration in precision medicine is most noteworthy. Singapore actively invests in genomics research and applications, aiming to improve public health and reduce medical expenditures through individualized disease prevention and treatment methods. The promotion of precision medicine helps to understand each individual's health risks and needs more accurately, thereby achieving more effective and cost-efficient healthcare management.

By drawing lessons from international examples, Taiwan can learn from the successes and failures of other countries in reforming its NHI system and develop health insurance strategies that align with its actual circumstances and future challenges. For instance, potential future directions for Taiwan's NHI reform include more extensive data sharing, increased investment in preventive medicine, promotion of innovation in medical technology, and further strengthening international exchanges and cooperation.

With global demographic changes and continuous advancements in medical technology, the sustainability and efficiency of health insurance have become critical issues that countries worldwide urgently need to address and resolve. Taiwan's NHI has provided invaluable medical resources and protection to countless people over the past few decades; however, the road ahead is full of challenges and uncertainties. From resource allocation, intergenerational equity, to the depth and breadth of technological applications, every aspect tests the wisdom of the government and the consensus of society.

Taiwan's collective mission and responsibility will be to find the most suitable model from successful international cases, create maximum value with limited resources, and while achieving efficiency, also ensure the quality of life, basic rights, and dignity of every individual.