It is widely recognized by the international community that health has become an essential human right, with significant universal value. Indeed, everyone knows that better health results in greater well-being for all the inhabitants of a country, which brings about beneficial consequences for the survival and development of a nation, and also for all of us who inhabit the Globe.
During the 77th World Health Assembly, which took place in Geneva between May 27 and June 1, 2024, its members adopted the 14th General Programme of Work of the World Health Organization (WHO) for the period 2025-2028.
This program basically includes the following strategic objectives: improving coverage of essential health services and enabling the financing of universal health coverage. WHO has urged Member States to take action in this regard.
It should be noted that Taiwan is several years ahead in implementing both objectives. Indeed, the island already developed its National Health Insurance (NHI) in 1995. This system, which unified the already existing labor insurance systems, has reached 30 years and currently covers 99.9% of the population. The NHI system provides equitable, accessible, and efficient medical care to all the people of Taiwan. It is an essential pillar, guaranteeing the island's social stability, as well as the health and safety of its citizens, becoming a global benchmark for achieving universal health coverage.
In an annual survey conducted by the website Numbeo, Taiwan has ranked first in the Health Care Index for seven consecutive years. This is a successful experience in today's world, where providing health care to all inhabitants has become a challenge and, often, a utopia. Perhaps this is the opportunity for different nations and WHO itself to focus on Taiwan as a reference and learning point to try similar successful solutions.
The NHI system operates with a copayment model when a medical service is received. It is fully self-sustaining, and it has been able to address the financial challenges posed by an aging population and the increase in medical care costs due to growing complexity and technological advances that have made new therapies and services available to the population. By adjusting premiums and adding additional sources of funding, such as the tobacco consumption tax, the system has been established on a solid and sustainable foundation.
The NHI covers the majority of the population and offers medical care with low copayments to prevent abuse of the system. Regular office visits have fixed copayments, of around, for example, US$3.33 (100 NTD – New Taiwan Dollar) per consultation with a general practitioner. If an insured person needs to be hospitalized, a coinsurance will be charged, with the rate varying according to the length of stay.
Copayment exemptions are allowed for certain groups, such as patients with catastrophic illnesses, childbirth, medical services in mountainous areas or on islands near the coast, low-income households, and veterans.
The current copayment for emergency care at medical centers is approximately US$26. The NHI covers a wide range of specialties, from acupuncture to dental care.
The NHI also reimburses health care in the private sector, allowing patients to freely choose the hospitals and doctors they prefer.
The copayment system seeks to balance accessibility to medical care with the responsible use of resources.
Meanwhile, the government of Taiwan launched in 2024 the vision of "Healthy Taiwan," whose objective is to ensure the good health of the population. This program, which keeps a focus on citizens, families, and communities, aims to expand health promotion actions and preventive medical care. A family doctor plan has also been implemented (something similar to what we call "primary care physicians" in Argentina), offering comprehensive care to patients with chronic diseases and using telemedicine to improve the accessibility of medical care in rural areas. By promoting integrated long-term care, palliative care, and aging at home, Taiwan seeks to guarantee dignified and comprehensive care throughout the entire life cycle for all its citizens, accompanying them in all stages of their existence.
In 2021, WHO developed and published the "Global Strategy on Digital Health 2020-2025", which encourages the adoption of people-centered digital health solutions to prevent, detect, and respond to infectious diseases. It also promotes the development of infrastructure and technological applications in order to leverage citizens' medical data, to promote the health and well-being of the population.
