RESUME ON JURNAL

BAHASA INGGRIS

AN OVERVIEW OF THE HEALTHCARE SYSTEM IN TAIWAN

OLEH :

KELOMPOK 1

AGENG LUHUR CAESAR 1610913410019

M. NOOR FUAD DZIL LUTHFA 1610913410012
NOOR FITRI ARIYANI 1610913420003
EVI DEWI PERMATA 1610913420004
HARTANTI WISNU WARDANI 1610913420009
PURWANTI NINGSIH 1610913420015

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS KEDOKTERAN

UNIVERSITAS LAMBUNG MANGKURAT

BANJARBARU

2016
 According to Wu et al, 2010 in the article An Overview of the Healthcare
System in Taiwan contended that Taiwan has a national health insurance system
that can be used for their citizens. In March 1995, the Taiwanese government started
to use the National Health Insurance (NHI) system. In addition, this insurance can
be taken to labour insurance, governmental employee insurance, farmers health
insurance, and fishermens health insurance. There is the procedure that they applied
from Department of Health until medical center, especially for the payment system.
However, the resources of their income came from employees, employers, and
government, so the insurance that the NHI members gave depends on their job and
income.
The Taiwanese NHI used retrospective (RPS) and prospective payment system.
The unit of payment particularly fees for service; nevertheless, for case payment is
used for certain diagnoses and per diem payment is allowed for chronic psychiatric
problem and community services. In January 2010, The Bureau of National Health
Insurance has used the diagnosis-related group system. The payment not influence
by the age; moreover, only the cancer screening programs and annual physical
checkups for people who the age older than 65.
An NHI member has an integrated circuit card (IC card). This card is
simplified to identify the NHI member, keep the medical record, and invoice the
insurance. Because of this card, the activity and payment made clear. In contrast, the
medical practitioners got their income from patient consultations, drug prescription,
and minor procedures. More so, the additional income also can be got from cosmetic
laser treatment, aesthetic surgery, or detailed health checkup.
There are several strengths of the NHI; i.e., good accessibility,
comprehensive coverage, short waiting times, low cost, high coverage rate, and
nationwide research databank. First, good accessibility, an NHI member might
directly see the doctor. The NHI system suggested the member go to medical
practitioner rather than hospital first because see the medical is cheaper. But, the
member often to meet a family doctor for minor illnesses, preventive care, health
checkups, consultations with multiple complaints. Second, comprehensive coverage,
cheap and abundant of care is a motto of the NHI system. The system flaps almost
all services. For instance, from dental care to parturition, from Western medicine to
traditional Chinese medicine, and from preventive services to elderly home care.
Third, short waiting times, the system made the member no waiting list and patient.
They can meet the specialist medical doctor directly in working times. Fourth, low
cost, the Department of Health established the global budget with physicians and
hospitals. The government kept the healthcare cost down with the best quality. Fifth,
high coverage rate, the coverage is about 99%. This number included all citizens of
Taiwanese, the citizens of Taiwanese who live in the other countries, foreign
nationals with legal residence, and others. Finally, nationwide research databank, the
identities of NHI members can not be recognized because the data is anonymous.
The data is kept in the Department of Health, but the databases are open to the public
with an application.
While, there is a view of the weakness of NHI, such as quality of outpatient
visit, weak referral system, and financial problem. The first weaknesses are the
quality of outpatient visit, because of the culture of the Taiwanese, the government
reports the average of the outpatient visit rate is about 14 times every year per person.
The second weaknesses are weak referral system, every NHI member easily to
access the specialist medical doctor, so that administrative health officer as a
gatekeeper for a family doctor is weak in Taiwan. In other words, the government
has a system that used as a problem solving, such as to promote the gatekeeper role
in the referral system and to give the discount for the specialist that refer the NHI
member into hospital medical center. The last weaknesses are the financial problem,
for emergency cases, the financial is made as financial dilemmas to the health system
because the government establishes the global budget depends on the care provided.
The Taiwanese currently does not have adequate money to cover all of the healthcare
provided.
As a conclusion, Wu et al, 2010 suggested that the Taiwanese government
ought to develop the quality of care whilst saving the national health care expense
with supervision. The government adopted the NHS from the United Kingdom that
developed the quality and outcomes framework (QOF) for the general practitioners.
QOF is developed to make the efficiency of financial problems.