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Development of the Healthcare system in Taiwan
Development of the healthcare system in Taiwan. Taiwan's economic miracle is well-known around the world. One of the reasons for its success is a sound public health infrastructure, which has paved the way for this economic breakthrough. The following is a brief introduction to the history of Taiwan's public health development.
A. The missionary period (1865-1895)
Several Western missionaries, including the earliest Dr. James Laidlaw Maxwell in 1864 and the later Dr. George L. Mackay in 1871 and Dr. David Landsborough in 1895, came to Taiwan from overseas with the intention of laying the groundwork for the development of Western medicine in Taiwan. Their sincerity and dedication to Taiwan won them the gratitude and respect of the local people. They opened the Gu Lau Hospital (now the Sin Lau Hospital) in Tainan, the Christian Hospital in Changhua, and the Mackay Hospital in Taipei, one after another, which became the three major privately-run medical facilities in Taiwan during this period.
B. Medical development during the Japanese rule (1895- 1945)
The foundation for early medical development in Taiwan mostly started during the period of Japanese colonization from 1895 to 1945. At that time, epidemics were prevalent in Taiwan due to the damp climate and poor hygienic conditions. The Japanese government realized that their lasting rule in Taiwan hinged on the effective control of such epidemics. As a result, they prioritized the effort to lay a solid foundation for Taiwan's public health system, which in effect improved the overall health of the Taiwanese people.
C. Public health after the government's relocation to Taiwan (1945-1995)

Taiwan's medical facilities were seriously damaged during the Second World War and much was to be done thereafter. As Taiwan is located in the sub-tropics, epidemics were frequent at the time. Health authorities decided to put medical progression on the back burner, and gave precedence to the fundamental development of a public health system. This policy served to lay a solid and strong foundation for Taiwan's medical advancement in later years. The major measures taken at the time included the wide establishment of health stations, the elimination of malaria, plague, and cholera, the application of universal vaccination, the promotion of women's and children's health and the improvement of family planning. It also promoted the construction of a health network prior to the launching of the National Health Insurance program.


Prior to the implementation of the National Health Insurance, Taiwan had 13 social insurances, such as Labor Insurance, Government Employees Insurance and Farmers Insurance, which provided composite social security benefits including health care coverage based on professions.  In 1986, the government officially announced that the National Health Insurance would be implemented. The Department of Health then set up the NHI Planning Team in 1991 and established a Provisional Office in 1993. On August 9, 1994, the NHI Act was enacted and put into effect.
D. The inception of the National Health Insurance and the reform of the National Health Insurance Administration, Ministry of Health and Welfare (1995-2013)

On January 1, 1995, the Bureau of National Health Insurance (BNHI) was established. On March 1, 1995, the National Health Insurance program was launched, and its important features include: mandatory enrollment, a single payer system, and premiums financed. On January 1 2004, the BNHI turned the NHI card from a paper one to a smart card which can serve a key of the information network between the patients, healthcare providers, and the BNHI.


On January 1, 2013, the 2nd Generation NHI was officially implemented and supplementary premiums were levied. To successfully implement the policies related to health and welfare, the health and welfare systems were integrated into a single ministry and the Department of Health was reinstituted to become the Ministry of Health and Welfare on July 23, the BNHI also had its name changed to the National Health Insurance Administration and became the agency responsible for the planning and implementation of policies.