Catastrophic Health Payment, Medical Impoverishment and Health Insurance Payment: from a Comparative Health System Perspective

Financial risk protection is one of the major policy objectives of implementing a social health insurance program. Nonetheless, the availability of health insurance inevitably is likely to result in moral hazard which consequently may increase household out-of-pocket payment and insurance payout. In response to escalating health care expenditures, the insurers have enacted both demand-side and supply-side cost containment measures. Whether the incidence of the financial cost will eventually fall upon the consumers remains an interesting question for research. As shown by some recent literatures, the extent and distribution of household out-of-pocket payment has been the key indicator adopted when assessing health system performance or health policy impact. As the financial gap enlarges, Bureau of National Health Insurance has developed many coping strategies over the years. There have been attempts to raise premiums and copayment on one hand, and tighten spending on the other. All these corresponding measures seem to deepen the financial burden on the households. However, empirical research which systematically examines the impact of relevant policies on the intensity and incidence of catastrophic health payment and potential medical impoverishment in Taiwan seems scant. Exploiting Health Interview Surveys, Surveys of Family Income and Expenditures, NHI claim data and the DOH Survey on Facilities and Service Volumes of Medical Institutions, this research aims to conduct a three-year study investigating catastrophic health payment, medical impoverishment and determinants of health insurance payment. As Taiwan and South Korea’s health care and health insurance system closely modeled those of Japan, comparative analyses of these three countries not only possess academic research value, but also will provide illuminating policy implications. The research findings are expected to address the gap in academic literature and provide valuable policy references.

Project ID:PF10001-0143
External Project ID:NSC99-2410-H182-003-MY3