Special Report: Health care in Taiwan
What can the U.S. learn from one of the world's best systems? Plenty.

A Taiwanese baby looks at a tube full of his own urine while waiting for a kidney stone test in a hospital in Taipei in 2008. Though far from perfect, Taiwan's single-payer health care system is one of the most highly praised in Asia. Its merits include the fact that 95 percent of Taiwan's 23 million people are covered, while in the U.S. more than 45 million are uninsured. (Nicky Loh/Reuters)
TAIPEI, Taiwan — Liu Hsiao-ling, a 58-year-old Taipei retiree, has Taiwanese friends who live in Chicago.
When they get so sick they need to see a doctor, they head for O'Hare and hop a plane for a 20-hour, cross-Pacific trip to Taiwan.
"The airline tickets are less expensive than getting treated in the U.S.," said Liu, as she sat in a hospital lounge in Taipei waiting to pick up her prescription. "And they say going to the doctor in Taiwan is much better than in America."
That's a damning indictment of America's overpriced, broken health care system — and a vote of confidence in Taiwan's.
So as politicians bicker in Washington over public options, "death panels," and all the other details of health care reform, this East Asian "tiger" may offer some useful lessons.
Taiwan has one of Asia's most highly-praised systems. Passed in 1995, it's a single-payer insurance system similar to Canada's. (Single-payer means only the government reimburses doctors and hospitals for the costs of health care).
Though far from perfect, its merits become clear in a few key statistics:
- Taiwan spends just 6.5 percent of its gross domestic product on health care; the U.S. spends more than 15 percent.
- Ninety-nine percent of Taiwan's 23 million population is covered; in the U.S., more than 45 million people remain uninsured.
- The administrative costs of Taiwan's system are a meager 1.5 percent, versus 20 to 30 percent for many U.S. insurance companies.
What it looks like
One misconception about "single-payer" plans like Taiwan's is that they eliminate free competition.
In fact, that's only true for the health insurance market, where the government becomes the dominant or only player. (In Taiwan, there is private insurance, but only for "gold-plated" plans targeting the wealthy, offering priority or tailored care better than what you can get through the national plan).
Health providers, on the other hand, work in a crowded market of both public and private facilities that compete fiercely for patients. The catch is, since reimbursement fees are standardized, doctors and hospitals don't compete on price.
It's like a town of a hundred hamburger joints, where the price of a hamburger is set at $1 — the restaurants would compete for customers based on how juicy, tasty and big their burgers are.
As a foreigner living in Taipei, I can attest that the health care system here is really excellent. Whenever I try to explain to my US based family and friends, they either act as if I am deluded or just plain lying to make a point--My father tells me when I get older I'll understand the importance of a good health system-- I have to remind him that I'm forty years old with two kids born here! Or they claim that the system is going bankrupt-- which is true-- it need to shore up its financial base-- but, is it there to make a profit? Changes are needed-- but they are just ways to extend efficiencies and reduce overuse.
as for the time spent with doctors- while in the US last, I took my Dad to see the pulmonologist in a private, well reputed clinic about his lung condition.
WE waited for forty minutes in the waiting roon-- -- saw the doctor for five minutes-- got a prescription- and were out the door. A lot like Taiwan if you ask me.
Its humiliating that a barely developed country like Taiwan can have such a sophisticated and effective health care and the US can't get its act together to do the same.
The cracks in the US veneer are showing-- rednecks with automatic rifles flaunt their supposed rights-- assassinations and coups are bandied about the right wing airwaves -- our savage redneck soul is being bared for the world to see-- the economy is in the tank-- we'll see if Obama can pull it together-- otherwise, we are looking at a long slow decline...
Interesting article. Wonder why we don't hear more about this system during the health care debate here in the States??
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