254779 Health care justice: What can the United States learn from Taiwan?

Tuesday, October 30, 2012 : 12:50 PM - 1:10 PM

Claudia Chaufan, MD, PhD , Institute for Health & Aging / Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA
Until 1995, Taiwan had a fragmented health insurance system that covered only 55% of its population, whereas the remainder 45% was unable to meet its most basic health care needs. Yet after a planning effort of about half a decade, and a strong, explicit commitment to health care equity on the part of government officials and the Taiwanese people, the country managed to replace their non-system with a national health insurance scheme that provides universal and comprehensive medical care according to medical need and not ability to pay. Further, the percentage of GDP spent by the system is substantially lower than the OECD average (~7% vs. 10%), its administrative costs are minuscule (under 2%), and waiting lists for medically necessary services are all but non existent. There is also evidence that since the system's implementation Taiwan has seen an important decrease in mortality for treatable conditions together with an increase in life expectancy. What explains the Taiwanese apparent miracle? Drawing from close to five years of teaching about Taiwan's health care system and personal experience teaching health care policy to graduate students in this island nation, this presentation will provide an overview of the Taiwanese health care system, the political, cultural and social contexts within which it came into being, and its strengths, weaknesses, and prospects. It will also suggest what the United States, plagued by over a century of struggles and failures to achieve healthcare justice, can learn from the Taiwanese model and experience.

Learning Areas:
Provision of health care to the public
Public health or related public policy

Learning Objectives:
1. Describe the main features of the Taiwanese health care system 2. Identify key differences between the Taiwanese and the American ways of financing health care 3. Explain how the method of financing health care in Taiwan allows for both cost control and coverage expansion 4. Evaluate the political, social and cultural antecedents that allowed Taiwan to implement major health care reform 5. Discuss how key features of the Taiwanese model can be applied to the American scenario

Keywords: Access to Health Care, Social Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted alone the research needed to elaborate this presentation. I have no conflicts of interest to disclose.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.