The equality of resource allocation in health care under the National Health Insurance System in Taiwan

Abstract

An ideal resource allocation in health care should ensure most people to access equal health care services while needed. Not only social welfare economists but also health policy makers concern with rational distribution of health care resources. Taiwan implemented a National Health Insurance (NHI) program in 1995, to reduce financial barriers for all residents with a universal health care system. Horizontal equity, an explicit goal of the NHI system, is to guarantee equal opportunity of access to health care. Accordingly, this study, utilizing cross-sectional data, proposes a multi-criteria decision-making approach with grey incidence analysis to measure horizontal equity of health care resource allocation of the NHI in Taiwan. From the findings of this empirical study, most resources are allocated in North Taiwan resulting in geographical disparity due to unbalanced health care resource allocation. And the large-scale hospitals are mostly congregated only at metropolitan regions; therefore, the access to health care services for patients in rural areas is still limited. Finally, the NHI in Taiwan is a single-payer for all hospitals, in which payment for health care suppliers can be adopted as an efficient strategy to induce the disparity of resource allocation and to redistribute national health care resource.