Uwe E. Reinhardt, an economics professor at Princeton University, praised the efficiency and effectiveness of Taiwan’s National Health Insurance system July 27, stating that the U.S. can learn from its integrated electronic operations.
In his article published online by The New York Times, Reinhardt highlighted the progress of the NHI for incorporating advanced health care technology to establish an electronic medical record system and fully computerized operation—something he said is lacking in America’s system that boasts highly trained medical personnel and luxurious health facilities.
“Oddly and sadly, however, the United States has yet to harvest the full benefit of modern electronic health information,” Reinhardt said. “Our nation’s engineers and entrepreneurs design smart hardware and software for health care, but we do not seem to use our own products as smartly as do many other countries.”
Launched in 1995, the NHI is a compulsory program that covers 99.6 percent of Taiwan’s population, including foreign nationals holding residency permits. Administrated by the NHI bureau under the ROC Department of Health, access is guaranteed for all through such measures as premium subsidies and installment plans.
According to Reinhardt, U.S. authorities should be “humbled” and learn from Taiwan’s 2009 introduction of computerized medical records and a central database network that links government administrative agencies, physicians and patients under strict conditions of privacy.
The clinical interface, now in its third year, already connects half of Taiwan’s 500 hospitals, Reinhardt said, adding that by 2016, it will include the remainder and 20,000 clinics.
This information network also includes electronic kiosks in about half of Taiwan’s hospitals, enabling patients to make an appointment with a doctor or review medical records by using an identification card.
Even technicians working in mobile clinics traveling through rural areas, Reinhardt said, are equipped with laptops patched in to the NHI data center.
Although interhealth services data sharing is rare in the U.S., Reinhardt said he had proposed such a system for New Jersey in 2008, but the U.S. has a long way to come in reaching Taiwan’s standards, he added.
Reinhardt acknowledged, however, that the NHI system is not perfect, as its expenditures account for only 6.7 percent of Taiwan’s gross domestic product, a rate lower than many countries of the Organisation for Economic Co-operation and Development. Another problem is that the island needs a larger supply of doctors.
“But a national health system must be judged not only by the level of health care it delivers, but by what it offers its citizens for the money they spend on it—by its cost-effectiveness, in professional jargon.”
