Abstract
Health systems reform in TaiwanThis documentary study presented the developing process of health system in Taiwan. Strategies, tools, and other experiences those are applied to solve health problems in Taiwan will be learned Taiwan has succeedded in economics and industrial developments as well as impressive gains in the health of the general population. However new health problems accompany with the rapid rising cost of health expenditure and access to care problems are primary factors for formulating policy in health reform in Taiwan.These are:Setting of medical care Network: to balance their medical resources,Applying the National Health Insurance(NHI) Project in 1995Creating Computerized Patients and Health Information Network to improve health service facilities, andDeveloping Family Practice Tranning Programs for their personal. This universal coverage NHI program creates monopsony buying power and promotes administrative efficiency. Fee-for service and co-payment are used as financial strategies.Although the health system reform is able to distribute providers and facilities to remote areas and gives a chance for the poor to access health services, the cost of health expenditure in still rising. Many payment mechanisms such as capitation, case payment, or global budget and other administrative strategies are proposed by experts to solve this problem. Many differencess between Taiwan and Thailand should be concerned when some health reform strategies will be brought to apply in our country. Very contrast to Thailand, the strength of economic sector and government in Taiwan make at least 2 programs, NHI program and medical care network program, possible. Thus, these strategies should be careful if implement in Thai society. Many tools for health system reform from the Western countries, however, many have limitations for solving health problems in oriental developing countries as Thailand.
