Health Care Service Supply System in Taiwan and the Taiwanese Government's Role in Equal Access to Health Care

Abstract

    This study examines the spatial structure of the health care service supply system in Taiwan; additionally, the study considers the Taiwanese governmentʼs role in ensuring equal access to health care. The results are outlined below.
    In Taiwan, a single medical insurance system has been adopted, and health care service supply is led by private medical institutions (along with Japan). Medical information on the entire Taiwanese population is collected and made electronically available. A hierarchical health care service supply system, with the medical centers at the top, has been developed based on the function of each medical institution. Accessibility to the medical institutions in mountainous areas or on isolated islands has now improved with the use of a cloudbased medical information system as a means of remote diagnosis.
    This institutional design depends largely on the legacy left by the Japanese during the colonial period. However, while acknowledging this legacy, this study clarifies the differences between the Taiwanese and Japanese systems. The post-war authoritarian government of Taiwan prioritized economic growth. This attitude is singled out as a particular factor that has caused the regional disparities between urban areas and mountainous areas and/or isolated islands. On the one hand, private medical institutions are concentrated in urban areas; on the other hand, mountainous areas and/or isolated islands are not completely supplied with sufficient health care services. Thus, the spatial formation of the health care service supply system has several different layers between urban areas and mountainous areas and/or isolated islands on the basis of the outcome of policy responses of successive governments in the post-war period. The existing spatial formation of the health care service supply system can be seen as a geographical consequence of the cycle of policy responses and the locational behavior of the medical institutions.