Taiwan National Health Insurance Department of Public Finance Hsienming Lien
Outline A brief introduction of NHI Some numbers on Taiwan’s health spending Some factors affecting health spending Cost and benefit analysis
2008年主要國家每人平均NHE
National health spending Taiwan’s national health spending (NHE) grows steadily to $1129 in 2008。 Because %NHI growth > % GDP growth, NHE/GDP also grows steadily, around 6.9％ in 2009。 Taiwan’s health spending (NHE) is approximately the same as that of Korea, but lower than the majority of OECD countries。 In spite of high support, it is very difficult to raise the insurance premium of NHI
Waste in health spending
Waste in health spending
Extent of waste among respondent’s relatives
Interview with Jonathan Gruber What are the two or three most important questions that public finance economists have not answered but need to? I like to say there are only two problems we have to worry about in America – healthcare spending and global warming because either one puts us underwater. How we control healthcare costs is probably the number one problem public finance economists and everyone in the world has to grapple with, because if we don’t control healthcare costs we’ll be bankrupt.
Possible factors for rising health spending Aging Increase of health insurance coverage Increase of personal income Waste
Break down inpatient health expenditure into several components Adm/1000, Days/1000 Length of stay per admission Adjusted Cost/day
Over the years, adjusted cost per day is the main driver of health spending, indicating technology innovation is probably the most important factor
Cost and benefit analysis/Cutler (2004) Medical costs 1950：＄500 2000：＄4500
Medical benefits? Live longer Live better
Costs of neonatal care 高雄市某環境科技公司參加去年底的哥本哈根氣候會議，公司指派懷有六個多月身孕的鍾女擔任隨團工作人員。在閉幕日的十二月十八日，鍾女突然出血，前往馬摩爾大學醫院就醫，並立即剖腹，產下體重僅一千公克的早產兒，寶寶置於保溫箱中，今年三月底才出院返國。 該院嬰兒保溫箱每日費用達新台幣二萬七千元，母子二人的醫療費近四百萬元。但健保能核退的費用僅門診一千五百九十五元、急診二千七百四十元、住院每日六千七百五十三元、生產三萬六千三百三十五元，總額約十二萬元。(自由時報，20100419)