History of the Insurance System
From 1950, Taiwan launched several social insurance programs including labor insurance, government employee insurance, and farmer insurance. Up to 1995, 59% of the population was covered. However, the programs were aimed at the employed, leaving children below 14 and senior citizens over 65 unprotected by any health insurance program. Prompted by the ideals of implementing universal health coverage, and solving social problems caused by poverty and illness, the government sought to integrate medical insurance from various social insurance programs into a more complete National Health Insurance in 1995. This constitutes an important milestone for the medical history of Taiwan. The following introduces major health insurance programs before 1995 in Taiwan.

1. Labor Insurance Labor insurance was launched on May 1, 1950. The program was aimed at the blue-collar workers of government-run enterprises, private company employees, workers in the mining industry, farming industry, forestry, tea plantation, employees of government agencies,
	◆ Excellent newborn care
transportation and communications, mass media, culture industry, public welfareand co-operative enterprises who were over 15 and under 60 years old. The benefits included compensation for childbirth, illness, injury, disability, elderly care, death, and occupational injury. Medical benefits were excluded after the launch of NHI in 1995. The current average premium rate is 5.55% of insured payroll. (Sources: Bureau of Labor Insurance)

2. Government Employee Insurance
Started in January 1958, the programs covered the employees of government agencies. The benefits included childbirth, illness, injury, disability, elderly care, death, and dependent funeral expenses. After the implementation of NHI, medical benefits such as childbirth, illness, and injury were subsumed into NHI. The current premium rate for government employees is 7.15% of insured payroll. (Source: Government Employee Insurance Act and Central Trust of China)

3. Farmer Insurance Farmer insurance was implemented on October 25, 1985, targeting self-employed farmers, tenant farmers, hired-hand workers, and spouses of self-employed and tenant farmers who were over 15 years old. The benefits included medical benefits for injury, illness, and cash compensation for childbirth, disability, and death. Medical benefits were integrated into NHI after the establishment of NHI. The current premium rate of Farmer Insurance is 2.55% of insured payroll. (Source: Bureau of Labor Insurance)

◆ Full insurance coverage for both mother and newborn

National Health Insurance Program
National health insurance is a mandatory enrolled social insurance. After the launch of NHI on March 1, 1995, the program provided for the right of the public to access medical care equally. DOH is the authority of the National Health Insurance Program, and BNHI is the insurer for NHI. The characteristics of the insurance is universal coverage, low premiums, comprehensive scope of benefits, easy access to medical treatment, proper care for disadvantaged groups, and high public satisfaction.

◆ Free medical service in outlying city	◆ Volunteer medical service to orphanage children

1. Enrollment
All citizens of R.O.C. and foreign residents who have lived in the Taiwan area for more than four months are required to join the insurance program. As of the end of August 2005, there were 22,129,646 individuals enrolled in the NHI with a coverage rate of 99%.

2. Premiums
NHI premiums are collected from the insured, group insurance applicant (employer), and the government, where 40% of the total premium revenue comes from the insured, 33% from the employer, and 27% from government subsidies. The percentage of the premium payment is 96.38%. The premium of the insured is calculated according to the insurable income, premium rate, share of contribution, and number of payable dependents. Unemployed citizens pay a flat-rated premium calculated from the average premium of all the insured people.

3. Number of Contract Hospitals
As of the end of June 2005, the BNHI contracted 575 medical institutions, which represent 98% of Taiwan’s medical institutions nationwide.