Taiwan uses smartcards and a premium on capital-gains taxes to keep health care affordable

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      In 2008, the PBS current-affairs show Frontline broadcast an intriguing documentary about health-care systems in five capitalist countries: the United Kingdom, Japan, Germany, Taiwan (Republic of China), and Switzerland.

      Taiwan, in particular, garnered high marks for keeping costs low while providing universal coverage through a single-payer government-insurance system. Its National Health Insurance model was adopted in 1995 borrowing best practices from other countries.

      At the time of the Frontline broadcast, the average family of four paid $650 per year with copayments of 20 percent for the cost of drugs up to $6.50. Even with those low costs, there were exemptions for major diseases, the poor, veterans, and childbirth.

      Eventually, the cost pressures became too much, so there were revisions introduced in 2011 to bring more money into the system.

      In advance of this week's World Health Assemby taking place in Geneva, Taiwan's health and welfare minister, Chiang Been-Huang, wrote an article highlighting the current system.

      "A key component of this change was the levying of a two percent supplementary premium on capital gains and unearned income," he stated.

      Unlike in B.C., medical-service premiums are linked to monthly salaries. The more you make, the more you pay. Health-care premiums are not a regressive tax in Taiwan.

      Taiwan also relies much more heavily than B.C. on electronic records, enabling different providers to have quick access to patients' histories.

      Patients carry an integrated smartcard, which allows them to retrieve their own records on short notice. This makes them more aware of how much health resources they're consuming.

      According to Chiang, these measures have helped keep the administration costs down to 1.07 percent of all medical expenditures—the lowest rate in the world.

      This year, the World Health Organization is allowing people to follow the World Health Assembly live on a webcast for the first time.

      On May 20, its member states approved a new global malaria strategy, which aims to eradicate the disease in 35 new countries by 2030.



      Devil's Avocado

      May 21, 2015 at 5:05pm

      "The more you make, the more you pay. Health-care premiums are not a regressive tax in Taiwan."

      That makes sense, so unlike the proposed Translink tax, it won't hit poor people the hardest?


      May 23, 2015 at 10:34pm

      Can you imagine the chaos if BC tried a "smart card" system? Think of Translink's half-baked abortion Compass, multiply the cost by 20 and you will be getting close to the financial costs. Our bureaucracy is designed to siphon money at increasing rates while providing fewer services. The health bureaucracy is, along with education, the most wasteful in the Province. Tens of millions of dollars are wasted on useless administrators and executives who have little impact on delivery of services except for taking money that should be spent on delivery of services.

      Solutions to the problems of our system invariably run aground when the chattering class gets outraged that most places offer some form of private care and still have coverage for all. The "pay what you can" aspect of Taiwan's program is wonderful but until the bureaucracy is culled we won't get beyond the ideologically hidebound mess that we have in place.