Yanrui Wu
University of Western Australia
The Emerging Health Care Market in Taiwan:
An Economic Analysis
Working Paper No. 92
April 1999
The views presented in this paper are those of the author(s) and do not necessarily reflect those of the
Asia Research Centre or Murdoch University.
© Copyright is held by the author(s) of each working paper: No part of this publication may be
republished, reprinted or reproduced in any form without the permission of the paper’s author(s).
National Library of Australia.
ISBN: 0-86905-690-5
ISSN: 1037-4612
CONTENTS
Acknowledgements
Executive summary
1
Introduction
2
Health care system in Taiwan
3
Health care resources
4
Demand for health care services
5
Trade and prospects
References
Appendix
Notes
1
ACKNOWLEDGMENTS
This research for the publications was supported by a grant from Asia Research Centre, Murdoch
University. The author thanks Cisca Spencer and Richard Robison for their support, Rongchang
Yang, Geoff Paton, Del Blakeway, Robert Roche and Mandy Miller for their assistance, comments
and suggestions at a seminar organised by the Asia Research Centre.
2
EXECUTIVE SUMMARY
Over the past four decades, Taiwan’s economy has achieved an average annual growth of
about 9 per cent. Due to such growth, Taiwan is now the world’s 14th largest trader and 25th richest
nation. It is also one of the few economies which have been less affected by the recent Asian
Currency Crisis. Economic growth in Taiwan has led to significant improvements in the economic
well-being of the populace as well as dramatic changes in the society. One of those changes is the
recent introduction of a universal health care scheme - the National Health Insurance Programme
(NHIP). The aim of the NHIP is to provide health care for all people. Its implementation has
important implications not only for the residents of Taiwan but also for the health care industry at
home and abroad.
The NHIP, put into effect in early 1995, has by now become very popular and attracted over
96 per cent of the total population. It is financed by contributions from both employers and
employees. The contributions vary among different occupation and income groups. The system has
been designed to encourage the use of referral and the separation of medical practice from medicine
dispensing.
Taiwan’s health care industry has been dominated by the private sector which operates over
88 and 97 per cent of Taiwan’s hospitals and clinics, respectively. 38 educational institutions are
involved in the training of medical personnel. On average, there are 868 persons per doctor and 211
persons per hospital bed. To promote the development of a modern pharmaceutical industry,
Taiwan’s economic planners have designated this industry one of the ten new industries in the 21st
century. The development and modernisation of traditional Chinese medicines is also regarded as
an important part of Taiwan’s health care programme.
These ambitious development goals are supported by burgeoning consumer demand for
goods and services. In 1995 an average Taiwanese household spent about US$2 300 on medical
goods and services. This figure has been expanding annually at the rate of 19 per cent. This growth
trend is set to continue due to rising incomes, an aging population and changing patterns of disease.
This growth gives rise to the changes in the health care sector and the emergence of a sizeable
goods and services market in Taiwan.
This emerging market will generate enormous opportunities for foreign providers. Taiwan has
been a net buyer of pharmaceuticals and equipment in the world market, though the government’s
long term goal is to become a net exporter. The Taiwanese market has been dominated by major
2
suppliers from Japan, North America and Europe. Newcomers will have to compete fiercely with
their counterparts from these regions. Given the geographic advantage and the fact that the market
has been opened to foreigners recently, Australian companies may have a competitive edge over
their rivals in areas such as pharmaceuticals, equipment, insurance and hospital construction and
management.
3
1 INTRODUCTION
Taiwan, one of the four well-known East Asian Tigers, has achieved spectacular economic
growth over the past four decades, with an average annual rate of 8.6 per cent. As a result, Taiwan’s
per capita GNP increased from less than US$200 in 1952 to over US$12000 in 1995 (Chiang 1996).
With a population of 22 million, Taiwan now has the 19th largest economy in the world and is the
world’s 14th largest trader and 25th richest nation.1 Rapid economic growth has led to significant
improvements in the standard of living of Taiwan’s populace. This is evident in the social and
economic indexes shown in Table 1.
Economic growth has also brought about social, political and economic changes in the Island.
Among these changes, the most noted is the emergence of an affluent class, i.e. the so-called middle
class or new rich. On the one hand, the new rich are the trend setters and hence the driving force of
social, economic and political changes. On the other hand, the island community, particularly the
island business community, has to cater for the needs of the new rich, from consumerism to political
changes.
This trend is reflected in the debate about Taiwan becoming a welfare state. In particular,
against the global trend of privatisation, the introduction of an universal health care system, namely
the National Health Insurance Programme (NHIP), was regarded as an important step in the process
of Taiwan becoming a modern, mature society. The purpose of the NHIP is to provide health care
for all people. Its implementation has important implications for the island’s 22 million people as
well as for the heath care industry at home and abroad.
The aim of this study is to present an economic analysis of the health care sector in Taiwan,
to gain some insight into this emerging health care market and hence to draw implications for
Australian health care providers. Section 2 presents an overview of the health care system in
Taiwan. This is followed by an examination of Taiwan’s health care resources in Section 3. An
analysis of household demand for health care goods and services is then shown in Section 4.
Finally, the opportunities for trade in health care goods and services in the Island is elaborated in
Section 5.
4
Table 1
Social and economic indicators, Taiwan
GNP per capita (US$)
Population (million)
Life expectancy at birth
Male
Female
Food intake per day
Energy (Kcal.)
Protein (gm)
Persons per doctor
Adult literacy rate (%)
1965
Taiwan
1975
1985
1995
HK
1995
M. China
1995
Japan
1995
US
1995
217
12.6
964
16.2
3297
19.3
12439
21.3
22990
6
620
1200
39640
125
26980
263
65
70
68
73
71
76
72
78
76
82
67
71
77
83
73
80
2411
61
1901
77
2722
75
1492
87
2756
80
1130
92
3090
96
777
94
3144*
n.a.
790**
92
2729*
n.a.
1060**
81
n.a.
n.a.
n.a.
99
n.a.
n.a.
n.a.
99
Sources Taiwan Statistical Data Book 1996
World Development Report 1997
Human Development Report 1997
Statistical Yearbook of China 1996
Notes
* 1992 figures
** 1994 figures
5
2 HEALTH CARE SYSTEM IN TAIWAN
2.1 Health care in historical perspective
Taiwan's health care system has evolved gradually since the early 1950s. The first labour
insurance regulation of Taiwan province was released in 1950, but the first insurance scheme
did not cover medical payment. Medical insurance was first introduced as part of the labour
insurance scheme in 1956. The initial policy provided hospital coverage only. In 1958 the
insurance regulation for public servants was implemented (Li 1996). The medical care
component of that regulation had important implications for the development of Taiwan's health
care system (Wu 1989). Since 1960, medical insurance was accessible to all employees and
fishermen. In 1970, this policy was further extended to cover farming workers. Participants in
the health scheme were classified into compulsory and voluntary groups (Wang 1985).
In 1971 the Department of Health and its local offices were formally set up, which
signalled the new era of health care management in Taiwan. Many medical regulations have
since then been added. As a result, there has been a substantial increase in the number of people
taking out medical insurance. By the end of 1983, the number of insurants increased from the
initial 128,000 to 3.3 million (Wang 1985).
The evolution of health care services has been accompanied by changes in the health care
structure. At present the organisational structure of Taiwan’s health care system consists of a
four-tiered hierarchy (Figure 1). At the top, the Department of Health of the Executive Yuan, the
highest executive body of Taiwan, administers and co-ordinates all health programmes
throughout the Island. The second-tier organisations are the Health Bureaux in the Province of
Taiwan, Taipei and Kaohsiung cities. At the third-level are the health centres in the 21 cities and
counties of Taiwan province, and in the districts of Taipei and Kaohsiung cities. At the grassroot level, health clinics and stations are set up in the towns, townships and city streets. In
addition, simple health facilities and services are also available in the villages.
6
Figure 1
Organisational structure of Taiwan’s health care system
2.2 National health insurance programme
On the 19th of July 1994, the so-called ‘national health insurance’ law was ratified. It
came into effect on March 1, 1995. To implement and administer the national health insurance
programme (NHIP), the National Health Insurance Bureau was founded on July 1 1995. The
Bureau has six local branches and twenty representative offices. About 14 710 medical
institutions, i.e. 91 per cent of the total in Taiwan, are contracted to provide services to this
programme (Li 1996). By the end of 1996, people covered under the NHIP amounted to over 21
million, i.e. about 96 per cent of the population. Amongst these are about 7.5 million people
who were previously not covered - mainly the elderly, children, students and housewives.
Reasons for NHIP
It seems that the introduction of a universal health care scheme is unavoidable at a certain
stage of economic development in all countries. Advanced countries have all followed this path.
The newly industrialised East Asian nations such as Singapore and Hong Kong adopted similar
health care schemes for their residents. Taiwan is no exception. The desire to gain the status of a
‘welfare’ state has driven the government to introduce the national health insurance programme
7
well ahead of original plans.2 The NHIP aims to provide adequate health care for all people,
since the previous public insurance scheme covered only 60 per cent of the population and left
many dependants uninsured.
In addition, due to increased life expectancy and improvements in public health, Taiwan is
increasingly becoming an ‘aged society’. People over 65 accounted for 7.1 per cent of total
population in 1993 and this figure is expected to reach 20 per cent within 40 years (Li 1996).
The group over 65 accounted for 28 per cent of total health care expenditure in 1995, and this is
expected to increase to one-third within ten years (Li 1996). Thus, the NHIP represents a nationwide cost sharing policy.
How the NHIP works
The NHIP is financed by contributions from employees through a percentage of their
salaries and from others through a poll tax. An upper limit is set at 6 per cent of wages and a
household pays for a maximum of six persons. The rates of contribution vary among different
occupation groups, with veterans and low income households paying nothing (Table 2).
NHIP members are provided with Insurance Cards and can pay for medical services following a
fixed fee scheme which specifies the payment for various services such as clinic visits, home
care and special treatment. A co-payment system has been implemented in order to split the cost
(between the insurer and the insured) and to minimise the total expenditure of health care (Table
3). The key element of the co-payment system is its encouragement of the use of referral. The
insured are required to bear 20 per cent of the cost of each visit to either out-patient clinics or
emergency care. Without referral, the insured have to pay 30, 40 and 50 per cent of the cost if
they visit clinics of district hospitals, regional hospitals and medical centres, respectively
(Department of Health 1996). However, these fees are waived for critical illness and injuries,
maternity, preventive treatment and for members of low income families. Ceiling prices are
imposed on drugs. Providers are reimbursed for the costs up to the ceiling limits.
8
Table 2
The rates of contribution
Groups
Government Employers Individuals Total
Contributions (%)
Government employees
Private school employees and their dependents
Salaried employees and their dependents
Part-time workers and their dependents
Farmers and fishermen and their dependents
Employers, self-employed and their dependents
Low-income families
Veterans
Dependents of veterans
Dependents of soliders
Others
Source
30
10
40
40
30
60
30
100
70
100
100
70
60
40
100
100
100
100
100
100
100
100
100
100
100
30
40
60
Department of Health (1996)
Table 3
Co-payment for outpatient care and hospitalisation (NT$)
Institutions
Outpatient visit
no referral referral
Medical centers
210
Regional hospitals
150
District hospitals
80
Primary care clinics
50
Co-payment for hospitalisation
Wards
80
80
50
1 to 30
Acute
Chronic
Source
60
30
60
40
10%
5%
Chronic visit
no referral referral
510
350
190
110
210
180
130
Days of stay
31 to 60 61 to 90
20%
10%
30%
10%
Special lab
test
Emergency
care
300
250
180
110
420
210
150
150
91 to 180
over 180
30%
20%
30%
30%
Department of Health (1996)
9
3 HEALTH CARE RESOURCES
3.1 Hospital resources
By the end of 1996, there were 16 645 hospitals and health clinics among which 773 were
hospitals (Department of Health 1997). The private sector has dominated the market, accounting
for 88 and 97 per cent of the hospitals and clinics, respectively. To improve the quality of
hospital services, a system of hospital accreditation was introduced for training in 1978, and for
medical services in 1988. Hospitals are assessed according to a set of criteria relating to the
quality of human resources, management, facilities and services. Hospitals are required to apply
for re-assessment every three years. By 1996, 547 institutions had met the requirements of
hospital accreditation. These include 12 medical centres, 43 regional hospitals, 63 district
teaching hospitals, 401 district hospitals, 3 speciality teaching hospitals, 7 psychiatric teaching
hospitals and 18 psychiatric hospitals (Department of Health 1997).
By the end of 1996, there were 104 111 hospital beds in Taiwan. Public hospitals
accounted for 36 per cent of the total beds. On average, there were 211 persons per bed in
Taiwan. This is comparable with mainland China’s 416 and Singapore’s 285.
3.2 Human resources
At the end of 1996, there were 123 829 medical personnel of whom 27 782 were
physicians and doctors of Chinese medicine (Table 4). On average, there were 868 persons per
physician, 7 194 persons per Chinese doctor and 2 967 per dentist. The number of persons per
physicians is expected to drop to 750 by the year 2000. Thus, it will be far smaller than
Thailand’s 4 420 and Malaysia’s 2 490 and closer to Australia’s 550 (Wu 1996).
The training of health personnel is provided by Taiwan's 38 medical schools, colleges and
high schools. In 1995, these institutions offered training to about 1 125 medical students, 271
dental students, 914 medical technicians, 1 327 pharmacists and 13 485 nurses and midwives
(Department of Health 1997). In recent years many overseas trained medical professionals have
returned to Taiwan and become an important part of the health system.
3.3 Pharmaceutical industry
10
Taiwan's pharmaceutical production started in the 1930s, largely stimulated by the
demand of Japan’s invasion of North China and later by World War II. By 1990, the output of
the pharmaceutical industry reached NT$30 billion (US$1.1 billion), about 0.7 per cent of the
world total (Zhang 1992). The government has an ambitious plan to develop the pharmaceutical
sector as one of the ten key industries in the 21st century, and to increase pharmaceutical output
up to NT$100 billion (US$3.7 billion) by the year 2000.
By the end of 1996, there were some 37 141 firms manufacturing and marketing
pharmaceutical products (Department of Health 1997). Amongst these were 6 438 pharmacies
and 642 pharmaceutical manufacturers of western medicines, Chinese herbal medicines and
medical devices (Table 5).
To improve the quality of pharmaceutical products, the ‘Good Manufacturing Practices’
(GMP) scheme was introduced to assess the producers and their products. Those who satisfy the
GMP criteria are issued with a certificate. By the end of 1996, 225 manufacturers had passed the
assessment. Traditionally, medicine dispensing and medical practice are handled together. One
of the objectives of the health care reform is to separate medicine dispensing from medical
practice. For this purpose, pharmacies are encouraged to participate in the co-payment system.
In addition, the management of pharmaceutical affairs is to be computerised in the near future so
that it can be more efficient.
Finally, the association of Taiwan’s medical equipment manufacturing industry had 124
members in 1994 (Ren 1995). The industry has been characterised by small-scale operations.
Little hi-tech medical equipment has been employed. As a result, Taiwan has mainly relied on
the world market for medical equipment and devices.
11
Table 4
Health manpower in Taiwan (end of 1996)
Categories
Physicians
Doctors of Chinese medicine
Dentists
Dental assistants
Pharmacists
Assistant pharmacists
Medical technologists
Medical technicians
Medical radiologists
Senior nurses
Nurses
Midwives
Nutritionists
Total
Source
Population per personnel
24,790
2,992
7,254
78
12,169
7,498
4,664
370
1,453
31,826
29,668
774
293
123,829
868
7,194
2,967
275,967
1,769
2,871
4,615
58,177
14,814
676
726
27,811
73,466
174
Department of Health (1997)
Table 5
Pharmacies and pharmaceutical firms (end of 1996)
Pharmacies
Pharmaceutical firms
manufacturers
Western
Chinese
Equipment
Dealers
Western
Chinese
Equipment
Total
Source
Total number
6,438
242
238
162
7,547
9,569
12,945
37,141
Department of Health 1997
12
3.4 Chinese medicines
Chinese medicines and pharmacies are still an important part of the medical system in
Taiwan. A committee on Chinese medicine and pharmacy was set up in November 1995. By the
end of 1995, 7 953 certificates had been issued to Chinese medicine doctors and 3 030 doctors
were in active practice. There were also 2 032 Chinese medicine hospitals and clinics among
which 99 were hospitals.
An information system has been set up to monitor the practice of Chinese medicine
doctors. Regulations were also formulated to judge the training and continuing education of
medical personnel.
4 DEMAND FOR HEALTH CARE SERVICES
The general trend of household spending on health care has been upward (Figure 2). The
average annual expenditure on medical goods and services has increased from about US$15.6
per capita in 1974 to US$570.4 per capita in 1995, an annual growth at the rate of 19 per cent.
Several factors have contributed to this growth.
Figure 2
Household annual spending on health care, 1974-95
2500
US$
2000
1500
1000
500
94
93
92
91
90
89
88
95
19
19
19
19
19
19
19
19
86
85
84
83
82
81
80
79
78
77
76
75
87
19
19
19
19
19
19
19
19
19
19
19
19
19
19
74
0
Source Report on the survey of family income and expenditure in Taiwan area of Republic of China, 1995, p.16
First, due to the rising income and subsequent increase in affordability, Taiwanese are
more concerned with their long term health and hence tend to spend more on health
improvement. In the past two decades, average disposable income per household has risen from
US$2 442 in 1974 to US$29 758 in 1995, with an average annual growth rate of 13 per cent. In
13
particular, as the share of food expenditure in household budgets declines over time, consumers
can now afford to spend more on other items such as leisure and health care. In 1995, an average
Taiwanese household spent about US$2 280 on health care. In total, health expenditure of
Taiwanese households amounted to US$12.2 billion in 1995.
The second important factor which affects demand for health care is the ageing population
in Taiwan (Figure 3). As the proportion of people at 65 and over increases, total health
expenditure will rise accordingly.
The third factor which is associated with population ageing is the changing disease pattern
in Taiwan (Table 6). This has placed new demands on the health system. In particular, the
system has to focus on chronic diseases such as cancer, heart diseases and diabetes mellitus
which have been the main causes of death in the Island.
With regard to demand for specific services, under the NHIP, the average number of visits
to a doctor in 1996 was about 14 per person per annum, the average number of hospitalisations
was about 12 per year for one hundred persons and the average days of hospital stay was about
9 days per person (Department of Health 1997b).
Figure 3
Proportion of population aged 65 and over
%
10
Source
1995
1993
1991
1989
1987
1985
1983
1981
1979
1977
1975
1973
1971
1969
1967
1965
1
Taiwan Statistical Data Book 1996
14
Table 6
Ten main causes of death (%)
1966
1976
1986
1995
Malignant neoplasms
Cerebrovascular disease
Accidents and adverse effects
Heart disease
Diabetes mellitus
Chronic liver disease and cirrhosis
Nephritis, nephrotic syndrome and
nephrosis
Pneumonia
Hypertensive disease
Bronchitis, emphysema and asthma
9.9
12.5
7.7
6.5
0.0
2.3
3.2
14.0
16.1
11.5
9.4
1.1
3.6
2.0
17.6
15.8
13.0
10.6
3.2
3.4
2.3
21.9
12.0
11.0
9.5
6.1
3.8
3.0
7.4
1.8
4.2
5.3
3.1
3.2
2.5
3.6
2.8
2.6
2.2
1.7
Sub-total
55.7
69.2
74.8
73.8
Total diseases
100
100
100
100
Source
Statistical Yearbook of the Republic of China 1996
5 PROSPECTS FOR TRADE IN HEALTH CARE GOODS AND
SERVICES
5.1 Internal and external trade
Taiwan’s health care market has for a long time been dominated by eight domestic
insurance companies. Under the pressure of trade liberalisation, the market was opened to
foreign providers for the first time in 1987. This was followed by the arrival of six United States
companies which introduced new concepts to the local market and hence helped expand and
improve health services in Taiwan. In the meantime, some new domestic companies also
entered the market. By the end of 1995, there were 15 domestic companies in the insurance
industry. Health insurance accounted for about 6 per cent of the total insurance market. Health
insurance premiums amounted to US$705 million in 1995, a rise of 22.4 per cent over the
preceding year (US Department of Commerce 1996).
15
Taiwan’s external trade in health goods and services is characterised by three main
features. First, 3 335 pharmaceutical importers were registered in 1995. Among these, 2 005
were engaged in importing medical equipment, 1 028 in importing western medicines and the
rest (302) in Chinese medicines. Most importers were based in Taipei and Kaohsiung cities.
Second, Taiwan has been a net buyer of health goods and services (Figure 4). The value of
pharmaceutical imports has increased rapidly, and this trend is set to continue in the future.
Third, with regard to market access, Taiwan has one of the least protected health care markets in
the region (Table 7).
While the Island’s goal is to become a net exporter of health goods and services, the
catch-up process will take a long time. The current health care expenditure of US$570 per capita
in Taiwan is far smaller than Japan’s $2 003, Australia’s $2 056 and America’s $4 782 (AIHW
1996). It can be predicted that per capita spending on health services in Taiwan will continue to
increase in the future. Thus, there are still ample opportunities for foreign providers of health
care goods and services.
16
Table 7
Tariff rates on health products of selected Asian countries
Products
HCDCS
Codes
Taiwan
G
MFN
Mainland China
G
MFN
Herb
Provitamins &
vitamins
Antibiotics
Other medicines
1211.90
29.41
0
2.5
0
0
20
20
15
15
29.36
2.5
0
20
30.01
30.02
30.03
30.04
30.05
30.06
5
0
20
20
7.5
10
90.18
90.19
90.20
90.21
90.22
90.23
5
2.5
3
3
2.5
7.5
Indonesia
Thailand
G
MFN
25
40
30
15
5
0
15
15
5
7.5
30
20
30
30
35
30
15
12
20
15
25
15
0
0
0
0
0
5
17
30
30
17
11
20
12
20
20
12
6
12
Korea
Australia Japan Philippines
10
8
8
0
0
5
0
30
10
30
15
8
0
0
3
40
5
5
5
20
5
25
25
30
30
30
30
10
10
20
20
15
15
8
0
8
8
8
8
0
0
0
0
5
5
0
0
0
0
0
0
10
20
20
10
10
10
5
20
20
10
0
5
30
30
30
30
30
30
10
8
8
8
8
8
8
5
5
5
5
5
0
0
0
0
0
0
0
10
10
10
10
10
10
Medical equipment
Source
Notes
20
APEC Tariff Database, APEC Secretariat, Canberra.
The rates are applicable in 1994-96, and quoted here only for the purpose of comparisons. For more details, please refer to the original sources.
HCDCS: the harmonized commodity description and coding system.
G: general tariff rates. MFN: preferential tariff rates.
17
Figure 5 Taiwan's total imports from Australia, 1989-96
3
2.5
US$ billion
2
1.5
1
0.5
0
1989
Source
1990
1991
1992
1993
1994
1995
1996
Monthly Statistics of Exports and Imports, Taiwan, January 1997, pp.140, 200
5.2 Business opportunities
Australia’s share in the overall Taiwan market is tiny. The specific market in health goods
and services is dominated by companies from the US, European Union and Japan. However, the
trend of Australian exports to Taiwan is upward (Figure 5). Given Australia’s geographic location
and advanced health care skills, Australian providers may have a competitive edge over their rivals.
Potential opportunities may exist in areas such as pharmaceutical, equipment, insurance and
hospital construction and management.
Pharmaceutical
Taiwan’s spending on imports of pharmaceuticals almost tripled in the last eight years, with
an average annual rate of growth of 13.3 per cent (Figure 4). In 1996, the size of the market was
over US$2 billion, with about US$1.45 billion in pharmaceutical and the rest in over-the-counter
drugs. Antibiotics alone amounted to 12% of the total market. Offshore and local suppliers have an
equal share of the market. The main foreign sources in 1996 were Switzerland, Germany, Italy and
the US.
Equipment
18
Taiwan has so far been a net buyer of medical equipment in the world market, though its aim
is to become a net exporter in the future (Ren 1995). Foreign products have a market share of about
80 per cent. During 1989-94, Taiwan’s imports increased from NT$6.156 billion to NT$15.1685
billion with an average growth rate of about 20 per cent per annum. The major suppliers, Japan, the
US and the EU, accounted for 37.24, 35.42 and 17 per cent, respectively. Taken together, they
accounted for 89.66 per cent of the Taiwanese market in medical equipment in 1994.
Insurance
Taiwan’s insurance market has only recently opened to offshore suppliers. There are still
opportunities for new entrants. Australian health providers will have to be competitive by, for
example, lowering premiums and delivering more diversified products. The latest development in
the market is the plan by the government to privatise the National Health Insurance Programme.
Though controversial, this privatisation programme will certainly create more opportunities for
offshore traders.
Hospital management
The modernisation of hospitals has always been part of the overall health care programme in
Taiwan. Taiwan has just under 800 private and public hospitals. Upgrading these hospitals is one of
the development goals. There will be opportunities for hospital construction, provision of
information systems and hospital management. Australian companies’ experience in other Asian
markets such as Singapore and Hong Kong can be very valuable for them to move into the Taiwan
health care market.
In summary, due to rapid economic growth and subsequent increases in income, Taiwan’s
health care sector is emerging as one of the main markets in Asia. Its importance has even been
strengthened in the midst of the Asian currency crisis as Taiwan’s economy and standard of living
have so far been less affected. Taiwan is in the process of developing a modern health care sector.
Ample opportunities exist in this emerging market. Australian health providers armed with
innovative products and know-how and their experience gained in other Asian markets may have a
competitive edge over their rivals from Europe, Japan and North America. Successful entries will of
course need a lot of patience and careful planning.
19
REFERENCES:
AIHW (Australian Institute of Health and Welfare), 1996, Health Expenditure Bulletin, No. 12,
p.24.
Chiang, P.K., 1996, “Ever increasing opportunities for Australia and Taiwan”, Industry of Free
China, 86, 61-70.
Council for Economic Planning and Development, 1996, Taiwan Statistical Data Book 1996,
Taiwan.
Department of Health, 1996, Review of Public Health in the Republic of China, Department of
Health, the Executive Yuan, Taiwan.
Department of Health, 1997a, Review of Public Health in the Republic of China, Department of
Health, the Executive Yuan, Taiwan.
Department of Health, 1997b, Report on the Assessment of National Health Insurance
Programme during 1995-96, Department of Health, the Executive Yuan, Taiwan.
Economic Daily News, 1996, Economic Yearbook of the Republic of China 1996.
Directorate-General of Budget, Accounting and Statistics, 1996, Statistical Yearbook of the
Republic of China 1996, the Executive Yuan, Taiwan.
Li, Zhingqiang, 1996, ‘Taiwan's health insurance toward the 21st century’, Industry of Free
China, 86, 1-36.
Ren, Kemin, 1995, ‘Exporting Taiwan’s Medical Equipment to the EEC Markets’, Bank of
Taiwan Quarterly, 46, 191-236.
United Nations, 1997, Human Development Report 1997, United Nations.
US Department of Commerce, 1996, ‘Health Insurance Review: Taiwan’, International Market
Insight (IMI960424).
Wang, J., 1985, A cross-country Study of health Insurance Systems, Maochan Books Co., Taipei.
Wu, Kaidong, 1989, Introduction to Health Insurance, Chinese Society of Social Security,
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Wu, Yanrui, 1996, ‘Trends and opportunities in China’s health care sector’, Policy Paper, 18,
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World Bank, 1996, World Development Report 1996, Washington D.C.
Xie, Mingrui and Xiufen Li, 1994, ‘On the National Health Care Expenditure’, Quarterly Journal
of the Bank of Taiwan, 45, 49-76.
20
Zhang, Yan, 1992, ‘Development of Taiwan's Pharmaceutical Industry’, Taiwan Economic
Research monthly, 15, 21-24.
21
APPENDIX: BUSINESS CONTACTS
Taipei Insurance Association
Taiwan Pharmaceutical Industry Association
3F, No.152, Sung Chiang Road
3F, 267 Tun Hwa S Road, Section 2
Taipei, Taiwan
Taipei, Taiwan
Tel: 886 2505 5891
Tel: 886 2738 7688
Fax: 886 2515 5390
Fax: 886 2738 7689
Department of Insurance
Bioindustry Development Association
Ministry of Finance
81 Chang Hsing Street
No.2, Ai Kuo W. Road
Taipei, Taiwan
Taipei, Taiwan
Tel: 886 2732 7226
Tel: 886 2322 8236
fax: 886 2732 8434
Fax: 886 2341 8374
Taipei International Medical Equipment
Bureau of Pharmaceutical Affairs
and Pharmaceutical Show
Department of Health
China External Trade & Development
100 Ai Kuo E. Road
Council
Taipei, Taiwan
4-7/F 333 Keelung Road, Section 1
Tel: 886 2321 0151
Taipei, Taiwan
Fax: 886 2397 1548
Tel: 886 2725 5200
Fax: 886 2757 6653
22
ENDNOTES
1
Based on 1995 figures (Chiang 1996).
2
NHIP was planned to be implemented in 2000 (Xie and Li 1994).