Political Feasibility Analysis of the New Financing Scheme for the National Health Insurance Reform in Taiwan: An Application of Stakeholder Analysis

Abstract

The National Health Insurance Program in Taiwan has just celebrated its 10th anniversary on 1 March 2005. In the past 10 years, the NHI Program has significantly transformed the ways people seek for medical services in Taiwan. According to recent statistics, the Program covers nearly all citizens and contracts around 92% of total hospitals and clinics. The public satisfaction rates with the Program have often been above 70%, and hence it is regarded as the most popular social policy in Taiwan.Nevertheless, the NHI Program is not that successful in terms of other aspects. For example, the financial status of the Program is not sound. Since 1998, the medical costs have exceeded the insurance revenue and therefore created large This study carries out in-depth political feasibility analysis of the prospective health financing reform currently taking place in Taiwan. The National Health Insurance (NHI) Program, which was established in Taiwan in 1995, covers virtually all of the island`s citizens. Between the years 2001 and 2004, the Taiwanese Government organized a taskforce to carry out the wholesale reform of the NHI program into the so-called ‘Second Generation NHI Program’. This study is part of the comprehensive review, focusing on the preferences and positions of key policy stakeholders with regard to the financial reform proposals, as well as their network relationships. The approach of stakeholder analysis was employed to conduct this empirical study. The results reveal that the new financing scheme has a certain degree of support from the policy stakeholders participating in this study, and that in particular, the measures concerning equity and sustainability were most welcome. However, controversy remains with regard to the issue of the equitable sharing of contributions. It is clear that there is much strong support for the new scheme amongst the administrative and legislative elite, although the same level of support is not evident amongst the social elite affiliated with employees` associations and welfare groups.