Intended for healthcare professionals

Observations Atlantic Crossing

Humbled in Taiwan

BMJ 2008; 336 doi: (Published 10 January 2008) Cite this as: BMJ 2008;336:72
  1. Uwe E Reinhardt, James Madison professor of political economy, Princeton University, Princeton, New Jersey
  1. reinhard{at}

    Taiwan’s highly efficient system of national health insurance should humble and inspire the United States

    Tagging along with Tsung-Mei Cheng, an expert on Taiwan’s health system, on her recent visit to Taiwan’s Bureau of National Health Insurance, turned out to be a bit humbling for me as someone who focuses mainly on the US health system.

    The bureau is the government agency that administers Taiwan’s single payer national health insurance system. Its staff members fret when hospitals and walk-in clinics fail to submit completed claims within the required 24 hours after delivery of service. Private health insurance companies in the United States count themselves lucky if high priced actuaries can tell them in the middle of the year what the carrier ultimately will have to pay the providers of health care for services rendered in the previous year. Taiwan’s bureau can track almost in real time what goes on in the nation’s healthcare system. In the US even a vague idea of what has been going on a year or two ago can be had only with the aid of a multimillion dollar, highly sophisticated health services research industry. …

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