站前學英文 | 菁英站前校【世界新聞專欄 CNN:美國健保制度應學習台灣


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Fareed Zakaria's Puzzling Take on Health Care in Britain, Taiwan, and Switzerland

 

 

Taiwan tries “Medicare for all”

Zakaria goes on to discuss the interesting case ofTaiwan. Taiwan recruited Harvard economist William Hsiao—best known among U.S. health wonks for hisinstitution of price controls under Medicare—to bring universal coverage to the island nation. In 1995, Taiwan instituted a single-payer plan called National Health Insurance, which can be fairly described as “Medicare for all.”

 

 

There is a single-payer system on the insurance side, but hospitals and doctors remain private. Within one year, Taiwan went from having an uninsured population of 41 percent to 8 percent. Every NHI patient carries a smart card, with 32 kilobytes of memory, that contains rudimentary patient and billing records: something that does a lot to limit wasteful and fraudulent spending in the Taiwanese system.

 

 

So, what’s not to like? Quite a lot. Recent health spending growth in the Taiwanese system is similar to that of the United States: about 5 to 6 percent a year. While the Taiwan government has succeeded in raising premiums twice to cover the rapid spending growth, these premium increases have been unpopular, and it’s likely that future governments will find it difficult to enact further premium increases. “Don’t expect politicians to do something unpopular like that very often,” notes Zakaria.

 

 

Already, the Taiwanese system is spending more on health care than it is taking in on premiums, and borrowing to finance the rest. The government is starting to ration care to keep spending in line with revenues.

 

 

 

When Taiwan’s single-payer system is 50 years old, like Medicare is today, it’s more likely to look like a failure than a success. Voters hold the line on premium increases, but have no control over system-wide spending. It’s a recipe for disaster.



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台灣的健保費即將調漲,讓很多人吃不消。不過美國有線電視網CNN的主持人「札卡利亞」,在研究各國的健保制度之後表示,台灣以政府的力量來支持全民健保,健保支出只佔全國GDP的7%,和美國的17%相比,台灣健保制度可說是非常有效率。

 

 

美國的健保制度歷經多次改革,但一直被民眾詬病,而美國有線電視網CNN的節目主持人札卡利亞,在研究各國的健保制度之後,認為台灣的全民健保值得美國做為借鏡。CNN節目主持人札卡利亞:「在台灣,他們決定做的是他們決定實施單一保險人,但由私人來提供,台灣的醫院是私人的,醫生是私人的,但卻由單一政府來成為保險人。」

 

 

札卡利亞指出,台灣的全民健保以低成本,提供民眾高水準的醫療服務,和美國甚至世界各國相比,確實較有效率。CNN節目主持人札卡利亞:「不令人意外,台灣有全世界最低的健保成本,他們只花7%的GDP在健保上,而我們(美國)花17%。」札卡利亞也指出,像瑞士也是採用和台灣類似的方法,都有政府的強力支持,盡量將所有的國民納入,而美國目前的健保系統一團亂,引起多方民怨,台灣和瑞士的作法,值得美國深思參考。

 

 

 

資料來源:

http://tw.news.yahoo.com/cnn-%E5%8F%B0%E7%81%A3%E5%81%A5%E4%BF%9D-%E5%80%BC%E5%BE%97%E7%BE%8E%E5%9C%8B%E5%80%9F%E9%8F%A1-003017541.html

http://www.forbes.com/sites/aroy/2012/03/19/fareed-zakarias-puzzling-take-on-health-care-in-britain-taiwan-and-switzerland/

 

 

 

 

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