1. THE TAIWAN EXPERIENCE Divergence, Convergence, and Intersections in Healthcare Systems

3. Chiu, H. (2011) National Health Expenditures/Capita

4. Life expectancy increase across all groups with the fastest rate of increase in lower classes Wen, CP., Tsai, SP., Chung, W.S.I. (2008)

5. NHI is funded by national health insurance premiums Bureau of National Health Insurance in Taiwan (2010); Chiu, H. (2011)

6. Distribution of expenditures across healthcare sectors Chiu, H. (2011)

7. Delivery of care in Taiwan with consideration of unique regional context Rationing healthcare using co- payments rather than a gatekeeper system Co-payments with global caps to prevent abuse and ensure healthcare is accessible Incorporation of TCM (Traditional Chinese Medicine) in the healthcare framework

8. Innovations & Strategies to Control Rising Expenditure Chiu, H. (2011)

9. Integrated Circuit (IC) Smart Card Implemented in 2001 Successful in reducing administration costs (2% of total expenditures) Information contained includes: – Personal information – NHI-related information including number of visits, communicable disease information, medical records – Medical services information including drug history, allergies – Public health administration information including vaccination, organ donation registry Image source: Jonathan Adams (Christian Science Monitor, 2009)

10. Delivery-side cost containment 1995 Fee-for-service (driving costs) 1998 Global budgets (financial incentive to contain costs) 2004 Resource-based relative-value scale 2010 Diagnosis related group reimbursement Taiwan Institute of Economic Research (2007)

11. Generating revenue through medical tourism

12. NHI 2.0 Will be implemented beginning in 2012 User-side cost containment measures – New strategies to limit “doctor shopping” Generating revenue through the re-structuring of premiums based on income tax – To take different sources of revenue into account (greater equity)