A Study on Organizational Type of Taiwan’s National Health Insurance System
Date Issued
2009
Date
2009
Author(s)
Chou, Hsiu-Chuan
Abstract
This study reviews the organizational problems of Taiwan’s present National Health Insurance (NHI) structure and its functioning. Literature review and in-depth interviews are conducted. Six possible forms of organizational reform are critically reviewed. Six reform options include: reform of the current health insurance system, a traditional administrative organization, an independent administrative Institution, agency, multiple insurers, and privatization. The first three options are preferred during the interviews.aiwan’s NHI system was established in 1995. Although the system is highly praised around the world, problems of the system have attracted serious public attention. Functional and organizational problems include: serious financial imbalance, inadequate linkage of premiums and expenses, unsatisfactory performance, lack of trust among stakeholders, low level of public participation, ambiguous organizational status, incompatible governance structure, and political interference.his study offers the following suggestions for the NHI organizational reform strategies: (1) The Health Insurance Act should be amended and Independent Administrative Institution Bill enacted; (2) committees governing premium revenues and medical expenses should be integrated to relieve the financial imbalance; (3) an external auditing organization should be established to rebuild the public confidence; (4) Department of Health and Bureau of National Health Insurance should reform their administrative systems to solve financial crisis; (5) organizational form of Independent Administrative Institution should be considered for the long term reform goal; (6) any reform measure of the NHI organization should consider its long term financial impact; (7) public involvement on NHI policy and budget should be encouraged; (8) the present performance bonus policy needs an overhaul; (9) general guidelines of organizational reform should be established.
Subjects
National Health Insurance
Health Insurance
Health Insurance Organization
Bureau of National Health Insurance
Independent Administrative Agency
Agency
Multiple Insurers
Reformation of National Health Insurance
Operation Bonus of National Health Insurance
Type
thesis
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