Taiwan has a well-established national health insurance system. The current health care system is known as National Health Insurance (NHI) and was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralizes the disbursement of health-care funds. The system promises equal access to health care for all citizens, and the population coverage reached 99% by the end of 2004. However, in order to make the insurance coverage universal, some costly but better treatments have to be paid by the patients themselves. There is no young adult clinic in Taiwan and there is a gap in the transition from youth to adult diabetic care. Many teachers, kids and the general public don’t understand what type 1 diabetes is.

What happens if you need to see a doctor?
Anyone can go to any hospital in Taiwan without a referral from a local hospital. The cost is only about 3-8 Euros for the outpatient clinic, medication, physical and chemical examinations.

Who decides what medicines a doctor can prescribe?
The Ministry of Health and Welfare (MOHW) has established the Taiwan Food and Drug Agency (TFDA) to handle pharmaceutical regulation. The TFDA must approve all pharmaceuticals imported to Taiwan before they can be marketed. The NHI of Taiwan then purchases drugs directly from pharmaceutical companies. In this way, the prices of the drugs are cheap, but the choices are very limited. Doctors can only prescribe those drugs available and for people with type 1 diabetes, that means only 4 kinds of insulin.

Practically, what is it like to live with type 1 diabetes in the Taiwan?
Living with diabetes in Taiwan is comparably easier than living with diabetes in many other countries because of the help from our national health insurance, but the problem lies in education. Patients do not like to tell others that they have type 1 diabetes. Many patients lack confidence and give up on themselves after diagnosis. The hope is to start up patient support groups to invite excellent diabetic patients to share their life stories to inspire others.

What about getting admitted to hospital?
Hospitalization is also covered by health insurance, but we do pay pay 20 Euros (4-bed room) to 60 Euros (single room) Euros per day.

How does diabetes care vary throughout the country?
The quality of health care is better in big cities than rural areas. But because there is not a medical referral system, patients can go to hospitals from local clinics to major teaching hospitals with only a small difference in the cost. This helps to bridge the urban-rural gap of diabetes care.

Thanks to Irene from Taiwan for this information.