Chi Pang Wen, MD, DrPH; Shan Pou Tsai, PhD; Wen-Shen Isabella Chung, MSc
The effects of implementing universal national health insurance are largely unknown.
Taiwan imiplemented national health insurance in 1995. In the decade before national insurance, differences in life expectancy between the healthiest and least healthy regions were increasing. Afterward, they decreased, but the gaps in life expectancy between the healthiest and least healthy regions remained large. Utilization and expenditures on health care increased, whereas the percentage of gross domestic product spent on health care remained at 5% to 6%.
The authors could not prove that universal national health insurance alone reduced health disparities.
Universal national health insurance may reduce health disparities, but only by a small amount.
Appendix Table 1.
*Increase in life expectancy during the period before NHI (from 1982–1984 to 1992–1994). †Increase in life expectancy during the period after NHI (from 1992–1994 to 2002–2004).
Pre-NHI was 1982–1984 to 1992–1994, and post-NHI was 1992–1994 to 2002–2004. Error bars represent 95% CIs.
HCG = health class group. Results are based on a modified cause–deletion life-table method, which assumes independence for each cause of death. Not all possible causes of death are included. Bars extending below the horizontal axis indicate that deaths from those causes contributed to reduced life expectancy, whereas bars extending above the horizontal axis contributed to improved life expectancy.
Appendix Table 2.
Appendix Table 3.
Appendix Table 4.
Appendix Table 5.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Wen CP, Tsai SP, Chung WI. A 10-Year Experience with Universal Health Insurance in Taiwan: Measuring Changes in Health and Health Disparity. Ann Intern Med. 2008;148:258-267. doi: 10.7326/0003-4819-148-4-200802190-00004
Download citation file:
Published: Ann Intern Med. 2008;148(4):258-267.
Healthcare Delivery and Policy.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only