US versus Taiwan Healthcare System Reforms: What Can India Learn from Them?

Abstract

India has been famous for producing excellent clinicians who have served the entire world. Moreover, India has been one of the medical tourism destinations for international patients. Yet, unfortunately, healthcare facilities and resources for Indian citizen are not up to the standard compared to other countries. In recent years, the Indian healthcare system has received wide attention by the various stakeholders, such as patients, healthcare providers, health insurance companies, Information and Communication Technology companies, the government, and investors. The government of India has taken a number of initiatives in order to streamline the healthcare system of India. As many others have reformed their healthcare system, it is good to learn from their success and failure. In this paper, we discuss healthcare reforms in the USA and Taiwan. We find that, despite a number of healthcare reforms, the USA is somewhat struggling, whereas Taiwan is relatively successful in streamlining their healthcare system. Also, we explore a possible reason (Optimizing Big Coefficient or New Reality theory) for this gap. Afterwards, we highlight ongoing healthcare reform in India, including what India can learn from the USA and Taiwan.

Differences in trends of perceived inpatient care quality based on regional socioeconomic level in the United States and Taiwan

“…The differences in health delivery systems between the United States and Taiwan may exacerbate differences in expectations regarding inpatient care quality. There is a general impression that the overall patient satisfaction rate might be higher in Taiwan than in the United States, owing to greater accessibility and the lower cost of care 10,13,28 . However, findings from the almost‐identical survey questions answered by discharged patients in the United States and Taiwan—and potential response tendency (items presented from most positive to most negative) that favored Taiwanese responses—we conclude that US respondents reported higher satisfaction overall.…”

“…8,9 Although significant reforms have occurred in the past few decades in the United States, healthrelated bankruptcies, access barriers, and unaccounted-for, wasteful administrative spending, still exist in new iterations of health care reform. 10 Although Obamacare's mandated coverage program slowed the percentage of the GDP spent on health care for the past decade, 11 uninsured populations have increased over the last 3 years. 12 Despite 99.9% coverage of care in Taiwan, the GDP share of health care spending has remained stable since the National Health Insurance (NHI) program was adopted in 1995, 13 which is comparable to that of Western nations such as Australia and Denmark.…”

“…While US health spending has been rising for many years—currently, at almost 18% of the GDP—Taiwan has kept its total health expenditure low, at approximately 6% of its GDP 8,9 . Although significant reforms have occurred in the past few decades in the United States, health‐related bankruptcies, access barriers, and unaccounted‐for, wasteful administrative spending, still exist in new iterations of health care reform 10 . Although Obamacare's mandated coverage program slowed the percentage of the GDP spent on health care for the past decade, 11 uninsured populations have increased over the last 3 years 12…”