Perspectives and Strategies after Implementing Global Budget Reimbursement System in the Health Insurance System in Taiwan

The effectiveness of Germany？？s practice to control inflating health care costs by way of global-budget policy seems attractive for the health-care planners in Taiwan. Comparative studies also show that it can achieve not only macroeconomic stability but also invaluable social peace. However, the strength of Germany？？s global-budget policy bases on the tradition of democratic collective bargaining and its comprehensive legal system. Without such an infrastructure, it is still unknown whether Taiwan will implant the global-budget policy smoothly and successfully. It should also be noted that global-budget policy does not necessarily deal with the claimed improvement of quality in health-care delivery or even distribution of health-care resources, not to mention the rise of professional autonomy or efficiency of performance. Even worse, it might distort the structure of ongoing health care system and lead the whole system to a new distress without a compatible framework. Global-budget policy bases on the consensus-building process via democratic collective bargaining, which is still embedded in a comprehensive legal framework. With such considerations in mind, this research will assess the possibilities and limits for Taiwan to introduce global-budget policy in the health care system. This research will also trace the development of global-budget policy in Germany and its adjusting measures following great challenges such as the unification of Germany and European integration. It will underline the ways to maintain a strained budgetary policy without sacrificing other policy goals, such as quality and accessibility of health care. Suggestions will also be made for further reforms.

Project ID:PG9201-0870
External Project ID:DOH91-NH-1012