Taiwan switched from US-style private health insurance to Canadian-style single-payer system, increased coverage from 60% to 99% and cut cost.
Back in 2009 the Anne Underwood writing for The New York Times interviewed William Hsiao, a professor of economics at the Harvard School of Public Health, who advised the Taiwan government during their 1990′s health care reform process. I just stumbled onto Ms. Underwood’s article Health Care Abroad: Taiwan today.
Key Lessons from Taiwan’s Reform Example:
- Primary reform was from private health insurance funding to single-payer funding through taxes. Use of mostly private doctors and hospitals did not change. Taiwan switched from an American model to a Canadian model.
- Universal Coverage: Taiwan’s old private insurance system left 40% without coverage, the reformed single payer system covers 99% of Taiwanese.
- 62% Lower Cost: Taiwan’s single-payer system costs 6% of GDP, compared to the US private system costing 16% of GDP.
- More Choice: Taiwan’s and other single-payer/private provider systems provide more choice of doctors and hospitals than the private insurer-dictated choices in the US.
- Higher Patient Approval: Taiwan’s system has a 75% approval rating, compared to the US private system’s 49% approval rating (Rasmussen, 2009).
- Opportunity for More Savings: Taiwan could cut cost (and probably improve patient health) even more by replacing their fee-for-service billing model with a health results-driven billing model, according to Professor Hsiao.
“You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.“
The U.S. had an opportunity like Taiwan’s to study the world’s best health care systems and borrow the best aspects of each to reform our system. A plague of money from the health care industrial complex overwhelmed our political system and President Obama’s leadership fell short, so we ended up with “reform” that tinkers around the edges.
Looks like we’ll have to wait for our private insurance system – currently in a death spiral – to completely collapse, causing the premature deaths of hundreds of thousands, maybe millions, of Americans and sucking up trillions of taxpayer dollars in the process, before we can revisit serious health care reform.
Maybe if Vermont’s single-payer universal care initiative gets past the Health Care Lobbyation Army and isn’t sabotaged by the industry or the Obama Administration, the likely success and popularity and savings for the emerging Vermont Model will be take up by other states. But I ain’t holdin’ my breath – especially for South Carolina, which would rather die of a toothache than consider such socialist evil as universal health care.