Overview

National Health Insurance: Taiwan‘s system is based on our own Medicare system (Australia and Canada too.) National Health Insurance (NHI) is a single payor model -or government financed –  not to be confused with the so-called “socialized” government run delivery. Socialized medicine is different than single payer.  In a single payer systems like national health insurance systems the government finances health care but services are provided by private hospitals and doctors. 

Social Insurance (Bismark model): Most Americans get their insurance their this model, through their employer. This model is usually finance jointly by employers and employees through payroll deductions. Several European countries favor this model, including Switzerland who has an entirely private insurance system, but private insurers can only make profits on supplemental insurance above and beyond the basic (quite comprehensive) package.

Socialized (Beveridge model):  These systems tend to have low costs per capita, because the government, as the sole payer, controls what doctors can do and what they can charge. Many, but not all, hospitals and clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government. The majority of the UK’s NHS is government financed and government run. In Britain, you never get a doctor bill.  However, many Americans might be surprised to learn there is still a significant private sector.  

Technically the only two true models of socialized medicine in the world are the VA in the United States and Cuba. Countries using the Beveridge plan or variations on it include the UK, Spain, most of Scandinavia, New Zealand, and Hong Kong. 

IT & EMR

A number of countries use a clever technology to keep individuals health records on electronic cards. Patients swipe their cards and their doctors receive their complete medical records

• Taiwan has Smart Cards
• Germany has Gesundheit cards
• France has Carte Vitale

You’ll probably be interested to know that the company the French imported this technology from was a company in St. Louis named Baxter. A fine example of US innovation exported to countries willing to implement improvements to their systems.

Objective: Examining the effects of health care reforms crossnationally in search of explanations for or against incremental reform in the US.

About Health: CARE

Health: CARE (Health: Crossnational vs. American Reform Efforts) is an attempt to describe and quantify the comparative successes and failures of select innovations and features of market-based reform efforts in 6 countries in Europe, Asia and the Middle East and draw implications for the American model.

The most and least successful reform features are determined by 3 criteria: effective reimbursement policy with well aligned incentives, cost-effectiveness and access to care. The reforms fall along the continuum of incremental to non-incremental (revolutionary) change.

Throughout the research inferences have been made on the type the reforms which had the best and worst affect on the health care system, and if any conclusions can be drawn on these relative successes and challenges for American health care reform.