Taiwan's National Health Insurance is often used as a ‘model for reform’ in countries such as the United States where health care depends on a private insurance system. A recent article written by Princeton professor Uwe Reinhardt in the New York Times blog also praises the efficiency of the Taiwanese system.
Yet, the inconvenient truth unknown to the outside world is that such efficiency is built upon exploitation of medical staff.
Professor Reinhardt's article was written after the 2012 Europe-Taiwan Health Dialogue held in Taipei in July. He was impressed by a presentation by the Director of the Medical Informatics Center at the Department of Health in Taiwan, who talked about the efficiency of the national health care data system which monitors infectious disease.
Even though Reinhardt acknowledged the fact that Taiwan's health care is underfunded with only 6.7 percent of its gross domestic product going to health care, compared with close to 18 percent being spent in the United States, he is unaware that this low budget is at the expense of medical staff in Taiwan.
The Taiwan Medical Alliance for Labour Justice and Patient Safety (TMAL) [zh] posted a table comparing the cost of some common medical procedures on their Facebook Page. It shows that in the U.S. 25-350 times higher is charged than what is charged in Taiwan for the same procedure. The Alliance explained:
TMAL further elaborated [zh] by quoting a comment made by Professor Jung-Der Wang from the Department of Public Health at the National Cheng Kung University on their Facebook page:
In addition to the high risk of sickness due to overwork, medical doctors in Taiwan face high volumes of medical malpractice lawsuits. Decode-medicine [zh], an online journal on Taiwan medical profession, highlighted the astonishing statistic concerning the prosecution and conviction rate of doctors in Taiwan:
The increasing number of lawsuits against medical doctors, along with long working hour and low salary, discourages young physicians from joining the five major medical departments [zh], including Internal Medicine, Surgery, Obstetrics and Gynecology, Pediatrics, and Emergency.
TMAL summarized [zh] the crisis of the National Health Insurance system in Taiwan: