Crediting Taiwan’s National Health Insurance for success in epidemic prevention

National Health Insurance (NHI) in Taiwan has been widely praised by international publications and credited for its role in the efforts of combating COVID-19.

The comprehensive medical coverage and digitalization of medical information provide the backbone for crucial actions by the C.D.C. such as Name-based Mask Distribution System and more.

National Health Insurance in Taiwan
The National Health Insurance has entered its 25th year and continues to receive international acclaim. According to the 2019 evaluation of the CEOWORLD magazine for the healthcare index of 89 countries, and the Numbeo 2020 Health Care Index evaluation, both ranked Taiwan’s system as first in the world. The National Health Insurance has played a critical role in combatting COVID-19 in a number of key ways.

(1) Single-payer System: The government implemented the National Health Insurance in 1995, combining the medical benefits of various insurances to form a single insurer— the National Health Insurance Administration (NHIA). The regular NHI premiums are calculated based on the insured’s monthly salary, and are shared by the insured, the employer, and the government. The insurance premium and copayment for disadvantaged groups are subsidized or reduced by the government. Because of this system, the policies put into place by the NHI to combat COVID-19 can benefit the Taiwanese people and the medical industry. 

(2) Comprehensive Medical Coverage: The universal health insurance covers all necessary medical care, including outpatient, inpatient, dental care, Chinese medicine and prescription drugs. Therefore, those patients suffering from COVID-19 do not need to worry about medical expenses incurred during treatment. Because of this comprehensive medical coverage, residents should not hesitate to seek medical treatment.

(3) Accessibility of Healthcare: NHI has contracted with approximately 93% of medical institutions nationwide (100% of hospitals, 92.6% of primary clinics, and 79.3% of pharmacies). People can visit medical institutions freely and pay only a fixed amount of copayment at the time of medical service, with the remaining costs covered by the NHI. In Taiwan, the average number of medical visits per person per year is about 15 times. Taiwan’s high-accessibility and low-copayment condition makes people habitually seek medical services when they are not feeling well. Thus, during the times of the epidemic, the medical profession can easily track or reach potential victims or patients with mild symptoms, which is a great aid in controlling the pandemic.

(4) Digitalization of Medical Information: Hospital claims submission and payment reimbursement systems are fully automated. The computer examines the medical claims of individual institutions to increase efficiency, and also makes Taiwan’s health insurance administrative costs among the lowest in the world (less than 1% of medical expenses). On the network system, a virtual private network (VPN) is used for data security. Throughout the COVID-19 pandemic, real-time sharing of medical information, such as travel history and medical history, is important to assist medical staff in discovering and tracing patients.

(5) IC-chipped NHI Card: The NHIA uses IC chip cards as insurance certificates, which can provide people with multiple smart functions. The health insurance card is an important link between the patient and the medical institution. The doctor can quickly obtain the patient’s recent medical information, which can also be used to track the patient during epidemic outbreaks, such as SARS in 2003 and COVID-19 in 2020. The use of the NHI IC card allows suspected cases to be monitored and detected in real time, assisting in containing the epidemic.

(6) Promoting Referral System: In order to improve the quality of medical care, Taiwan also promotes a tiered medical system. In addition to strengthening the service capacity of primary-level medical institutions, and raising the hospital’s payment for treating critical diseases, the NHIA has built a vertically integrated strategic alliance between hospitals and clinics. Large-scale hospitals take the lead in vertically integrated strategic alliances with neighboring primary-level medical institutions, and establishes a cooperative channel for transferring patients upstream or downstream. People can get medical care through this tiered medical system, avoiding cluster infections caused by a sudden influx of patients into one treatment center.

NHI Assists in Fighting COVID-19
(1)Warning remarks in The NHI MediCloud to manage cases: The NHIA shall put travel notifications in the NHI MediCloud on people who have been kept in home quarantine, and contact notifications on people kept in home isolation. Likewise, aircraft crew members, medical professionals, residents and workers at residential institutions for long-term care are all marked by their profession in the NHI MediCloud. If these aforementioned people visit a doctor, the risk for contracting COVID-19 can be properly evaluated.

(2)Diverting suspected cases to designated community laboratories: In order to establish a community screening network for COVID-19 and expand the capacity of medical services, the National Health Insurance Administration (NHIA) set designated community laboratories on the NHI e-Referral System. With this mechanism, doctors in local clinics can rapidly help a suspected COVID-19 patient screened within a community, and stop suspected cases from rushing to hospital emergency rooms, lowering the possibility of spreading the coronavirus in hospitals. The NHI MediCloud system will also indicate whether referred cases which is have not been screened.

(3) Name-based Mask Distribution System: The Name-based Mask Distribution System is based on the NHI card held by all residents. Under this system, people are required to use their NHI Card to purchase protective facial masks; the date and the amount of masks will be recorded in the NHI MediCould System. Purchasing masks directly at pharmacies is classified as “Name-based 1.0.” Online purchases are “Name-based 2.0,” and the recently-introduced ability to order at convenient stores’ kiosks are “Name-based 3.0.”

Compiled by the NHI, https://topics.mohw.gov.tw/COVID19/cp-4778-53691-206.html

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