Chiang T L
Institute of Public Health and Center for Health Policy Research, National Taiwan University, Taipei.
Health Policy. 1997 Mar;39(3):225-39. doi: 10.1016/s0168-8510(96)00877-9.
Under considerable domestic political pressure, the Taiwan government inaugurated a compulsory universal health insurance scheme on 1 March 1995. This new scheme is financed mainly by payroll tax and provides comprehensive health care benefits with a moderate cost sharing. In order to gain efficiency in delivering health services, the scheme enters contracts with health care providers and has been developing a prospective payment system. Meanwhile, the scheme uses a uniform fee schedule and makes all payments through a public single-payer system to control health care costs. By the end of the inaugural year, the scheme covered 92% of the population and the utilization pattern of the newly insured became close to that of the previously insured. However, there is the beginning of a financial crisis because the payments of the scheme are rapidly increasing and expect to exceed the premiums in the coming year. Besides, the scheme did not bring in the efficient use of health care resources and probably caused it to worsen. Taiwan's health care reform has an unfinished agenda.
在相当大的国内政治压力下，台湾地区政府于1995年3月1日启动了一项强制性全民健康保险计划。这项新计划主要由薪资税提供资金，并以适度的费用分担方式提供全面的医疗保健福利。为了提高医疗服务提供的效率，该计划与医疗服务提供者签订合同，并一直在发展一种前瞻性支付系统。同时，该计划采用统一的收费标准，并通过公共单一支付者系统进行所有支付，以控制医疗保健成本。到第一年年底，该计划覆盖了92%的人口，新参保者的使用模式已接近先前参保者。然而，一场金融危机已初现端倪，因为该计划的支出正在迅速增加，预计来年将超过保费收入。此外，该计划并未带来医疗保健资源的有效利用，甚至可能使其恶化。台湾地区的医疗改革仍有未完成的议程。
