Revelation of the second-generation national health care reform in Taiwan area on the equity and sustainability of the medicare fund in mainland China

VernacularTitle:台湾地区二代健保改革对大陆医保基金公平性及可持续性的启示
Author: Zhiyuan CHEN ; Rong JIANG ; Rong SHAO
Keywords: Second-generation national health insurance; Fair medical premium; Global budget; DRGs; Health technology assessment
From: Chinese Journal of Health Policy 2017;10(2):50-56
CountryChina
Language:Chinese
Abstract: This paper analyzes the reform backgrounds, mechanisms and measures of financing and payment taken in the second-generation national health insurance (NHI) in Taiwan. The results indicate that in 2nd NHI, the rate was adjusted more flexibly, supplementary insurance premium was charged to enlarge the financial source by im-plicating additional subsidies and expanding the sources of financing, multiple payment methods and auxiliary assis-tive means were used to control the growth of medical expenses, social insurance payments are specified in terms of category or clear payment projects and standards, new health technology assessments are used as new basis for deci-sion making, etc. by greatly alleviating the financial deficit, which helped achieve the financial balance again. Many features of the 2nd NHI in Taiwan, especially like its diversified financial resources and financing methods, global budget of control fees and DRGs payment systems, making evaluation criteria for medical quality control and health insurance reimbursement project development and so on, are worth learning for the mainland China.