Monthly Archives: April 2009

Taiwan’s well-oiled health care system serves as a model for US

On March 21st, over 250 people packed a conference room and spilled into the hallway of Santa Clara’s Hilton Hotel in order to learn about medical tourism in Taiwan. With one of the best healthcare systems in the world, Taiwan is actively touting its medical services overseas as a way of offsetting the island’s sluggish economy.

A group representing 14 private examination centers and medical products decided to target the four million overseas Chinese and test the US market. Among the facilities represented were the well-known Taipei Veterans General Hospital, Cheng Hsin Rehabilitation Medical Center, Kaohsiung Medical University Hospital, and the Buddhist Dalin Tzu Chi General Hospital.

Organized by Taiwan’s Ministry of Economic Affairs (MOEA) and the Taiwan Trade Center in San Francisco, the event was designed to promote the island’s quality healthcare system emphasizing the island’s state-of-the-art facilities and equipment, well-trained professionals and affordable prices. In addition to exceptional care, medical visitors can also enjoy Taiwan’s sights, and visit friends and family at the same time.

National Health Insurance

At the event, Dr. John Y. Jean, the CEO of Taipei Medical University Healthcare Group, spoke about Taiwan’s universal healthcare system, known as National Health Insurance (NHI). He said Taiwan’s healthcare system is recognized as the second best in the world after Switzerland.

NHI offers equal access, freedom to choose any doctor and no waiting time. John Reichard, CQ HealthBeat News Editor, wrote a detailed report entitled “Taiwan: Surprising Lessons from a Small Island” in last June’s CQ Politics () praising Taiwan’s NHI system.

Taiwan’s NHI is a single-payer system, meaning only the government has the authority to handle payments. The single-payer approach is the key to keeping the costs generally affordable. The funds left over by healthy people with low medical costs can be used to pay for care of the sick.

Adopted in 1995, NHI offers universal coverage to over 22.6 million people. Before NHI, about 60 percent of the population had health insurance coverage and health costs were growing at double-digit rates. Now 99 percent of the population is covered and health costs are rising at around 5 percent annually.

In order to standardize quality care, Taiwan began its hospital accreditation program in 1978. After studying several American hospital accreditation systems, Taiwan’s Joint Commission on Hospital Accreditation (TJCHA) was formed in 1999. Dr. Jean, with 20 years of medical experience in Taiwan and America, said the system is a headache for each member hospital, but it is instrumental towards maintaining the high quality of hospital services on the island.

Another reason for Taiwan’s healthcare success can be attributed to the widespread provision of high-tech equipment in hospitals: 321 computer tomography (CT) scanners, 115 magnetic resonance imaging (MRI) scanners, 33 positron emission tomography (PET) scanners, and even some spiral MRI, which is very scarce globally.

Quality, affordable healthcare with minor hiccups

The advantage enjoyed by Taiwan’s people is affordable healthcare. As an example, the cost of a liver transplant in Taiwan is one-fifth to one-sixth of the same procedure in the US or UK. The cost of performing a coronary artery bypass graft (CABG) is about one-fifth of the cost in the US. The average cost of a of hip replacement in Taiwan is 17 percent of that charged in the US and 20 percent of that in the UK, 39 percent of that in Singapore and 50 percent of that in Thailand.

Taiwan is also a great destination for cosmetic surgery. The price of various plastic surgery procedures, including rhinoplasty, liposuction, and breast implants, is about one-third less than in the US. Dental implants, excimer laser surgery, and in-vitro fertilization (IVF) are 50 to 80 percent less costly than in the US.

Overall, average surgery costs in Taiwan are one-fifth of those in the US, and one-sixth those in Britain. In addition to more affordable surgical procedures, regular examinations and diagnostic tests also cost less. Costs of performing an endoscopy, colonoscopy sigmoidoscopy, or CT scan are about one-seventeenth of the price paid in the US.

In Santa Clara last month, Dr. Po-tung Chen, director of Show Chwan Health Care System, said it is common for seniors to have knee joint replacements. However, it is extremely costly and many are not covered by basic health insurance. The cost of this kind of increasingly common surgery in Taiwan is about one-third of that in the US.

Despite its success, Taiwan’s NHI struggles too. The biggest challenge is to balance its growing expenditure, growing at 5.5 percent, with revenues that are growing at an average rate of 4.7 percent. To offset this difference, the NHI system borrowed about NT$40 billion (US$3.2 billion) from banks, while lawmakers are considering the adoption of a new bill aimed at expanding the tax base funding the system.

In Taiwan, healthcare costs account for 6.16 percent of the island’s gross domestic product (GDP), while the US spends about 16 percent of its GDP on healthcare, yet still leaving 45 million people with no health insurance.

US hesitation

The US tends to regard the single-payer system as bureaucratic and inefficient. But Taiwan’s NHI has proven otherwise. The island’s administrative costs average under two percent of all healthcare spending while in the US administrative costs consumes 15-30 percent of all healthcare spending. Since everyone in Taiwan carries an insurance card with Smart technology imbedded, their medical information is readily available to doctors and healthcare administrators, saving both time and paperwork.

The US Congress is also generally resistant to the notion of a single-payer system because many congressional analysts consider it to be under-funded and fear it would curtail the profits needed to fund America’s medical innovation. Besides, US drug companies and insurance firms are major sources of political campaign donations.

Earlier this month, US Nobel Laureate Paul Krugman talked to the World Journal about his upcoming trip to Taiwan in May. Krugman said the US should have adopted a single-payer healthcare system like Taiwan’s after World War II. He added that the US government will face strong resistance from deeply rooted interest groups, but praised Taiwan’s healthcare system as one that “can show the Americans that it works.”

Michigan House Democrat John Conyers, Jr. is sponsoring legislation (HR 676) that would bring to the US a single-payer system. Advocates argue the system is hardly foreign in the US. After all, Medicare is a single payer system popular among seniors; although with vast spiraling costs as well.

Even ardent single-payer supporters agree that a US adoption of such a system would have to be a gradual process. The universal coverage plan developed by former Senator Hillary R. Clinton, involves competition between government and private entities.

Although Taiwan’s NHI may not be perfect, it is continuously striving to improve the quality of health and life in Taiwan. Its success is reflected by an increase in the island’s life expectancy in just two years. In 2005, life expectancy for men was 73.7, and for women 79. In 2007 this had increased to 75 and 81.9 respectively. Furthermore, the system has consistently won high satisfaction ratings of around 70 percent. More importantly, it has enabled the Taiwan government to reassure its people that they will be well cared for regardless of their individual circumstances.

Overseas compatriot minister visits San Francisco

On March 19th, the minister of Taiwan’s Overseas Compatriot Affairs Commission (OCAC) Dr. Wu Ying-yih stopped in San Francisco to allay concerns about the planned merger of his organization with the Ministry of Foreign Affairs (MOFA). Rather than a downgrade of services as some have worried, Wu announced that the consolidation of government departments would in fact result in an upgrade of services to the overseas Chinese community.

Wu’s arrival in San Francisco was the first stop on a week-long tour of the United States. He was accompanied by Dr. Jiang Yi-huah, Taiwan’s minister of the Research, Development and Evaluation Commission (RDEC) who heads the government’s reorganization. During their visit, the two ministers held a series of seminars to dispel concerns about the merger.

While in San Francisco, the overseas Chinese community expressed their concerns over the proposed merger, as well as their fear that their voices will go unheard and their opinions ignored in the future. With over a million ethnic Chinese in the US, the San Francisco community urged the government in Taiwan not to deny them a say. These overseas compatriots cited Dr. Sun Yat-sun, the founding father of the Republic of China (ROC), who described the overseas Chinese as “the mother” of the republic because most of the funding for the ROC’s revolution in 1911 came from overseas Chinese pockets. More recently, the overseas community has played a crucial role in Taiwan’s democratic transformation. Even today, the Legislative Yuan (Taiwan’s parliament) still reserves some seats for overseas Chinese.

According to the World Journal, one of the most widely read Chinese-language newspapers in the US, Wu explained that the OCAC will not be “swallowed” up by the Foreign Ministry, instead the new body will have a bigger budget and a dedicated special vice minister to deal with the interests of the overseas Chinese community.

Wu tried to allay the worries of the local overseas Chinese community by explaining that they will be better served with more regional offices after the consolidation. Currently, the OCAC has only 16 overseas offices while the Ministry of Foreign Affairs maintains 121 overseas offices.

While addressing a group of Taiwanese expatriates from Japan, President Ma Ying-jeou assured them that the efforts to streamline an overly bureaucratic government will result in the provision of better services to more overseas compatriots.

Ma emphasized the value of Taiwan’s overseas compatriots in playing a positive and effective role in humanitarian work and cultural exchanges – one that is more effective than government aid could ever be alone. The president said services to overseas Chinese will be improved after the reorganization is implemented in 2011, reported Taiwan News.

The OCAC will not be the only organization affected by the streamlining plan of the Ma administration, the government plans to whittle down the number of ministries and commissions from 37 to 28.

Taiwanese Americans to be counted in next US census

At the next US census in 2010, Taiwanese Americans will – for the first time – be given the choice to distinguish themselves from Chinese Americans. This will enable the US government to know exactly how many people originated from Taiwan, as opposed to other countries in Asia, according to the World Journal, the most read Chinese-language newspaper in the United States.

David Choy, the Asian-Pacific Specialist at the US Census Bureau’s Seattle Regional Office said, that in the 2000 US Census 500,000 people classified themselves as “Taiwanese” and filled in the blank space on the census as such. The general statistics of the census will be formally published later this year and then submitted to each state and local government.

The census is mandated by the US Constitution and conducted every ten years. The results of the census are used to allocate congressional seats and electoral votes. More importantly, it is instrumental in determining how government funds are allocated, since the ethnic makeup of the US also determines how development funds are divided to ensure that the political will of each ethnic group is exercised.

The decennial census will start April 1, 2010. The Seattle regional office covers the states of Washington, Oregon, Idaho, Alaska, and northern California. Choy said the ratio of Asian’s in the region’s population is growing and becoming more important. Asian immigrants are encouraged to take part in the coming census.

Taiwanese film wins Golden Gates Award at the SF International Film Festival

Director Chiang Hsiu-chiung’s film Artemisia has won this year’s Golden Gate Award for a Television Narrative Feature at the 52nd San Francisco International Film Festival – April 23 to May 7, 2009. Her well-crafted debut script focuses on the resilience of family.

As a young women, Ai-tsao, defied her conservative family to marry the man she loved. Now 58 years old and widowed for over 20 years, she is struggling to accept her money-focused mother, her unmarried daughter’s mixed-race baby and her closeted gay son. Amid it all, she works toward accepting and preserving her family. The film screens April 26 (Sunday) at 9:15PM, May 3 (Sunday) at 12:45PM and May 7 (Thursday) at 8:30PM at the Sundance Kabuki Cinemas. The director will participate in a Q & A session after the May 3rd showing. For more information, please visit: , or call .

Fresno City College shows Taiwanese films on April 28th

In celebration of Asian American Month 2009, Fresno City College will be showing two Taiwanese films on Tuesday, April 28th in the Student Lounge. Chocolate Rap, is a story about Choco, a young man whose passion for dancing conflicts with his father’s more practical expectations. The film will screen at 4PM. Three Times by renowned director Hou Hsiao-hsien will screen at 6PM.

The movie focuses on three tales of love (1911, 1966 and 2005) set in different eras. Each screening will be followed by a Q&A session with faculty member John Cho and Manfred Peng, director of the Press Division-TECO. For more information about the program, please contact College Activities at or John Cho at , extension. 8349. .

Taiwan commemorates the 30th Anniversary of TRA with new cross-strait stability

On March 24th, the US House of Representatives once again pledged its “unwavering commitment” to the Taiwan Relations Act (TRA) and called it the “the cornerstone of US relationship with Taiwan.” In recognition of the 30th anniversary of the TRA, Congress strongly backed the resolution with a unanimous vote. The next day, a group of 30 senators wrote to President Barack Obama asking him to reaffirm Washington’s commitment to the TRA.

In 1979, Taiwan was left diplomatically adrift after President Carter announced his intention to switch diplomatic relations from the Republic of China (ROC) on Taiwan to the People’s Republic of China (PRC). In order to continue relations with the island and to protect Taiwan from mainland Chinese aggression, the US Congress and the Senate overwhelmingly passed the TRA on April 10th of that year. Since then, the TRA has successfully protected Taiwan and preserved peace in the Taiwan Strait. Moreover, the island, as one of the strongest allies of the US in Asia, has become a robust and free economy with an American-styled democracy.

When President Carter recognized the PRC in Taiwan’s stead, he also nullified the Mutual Defense Treaty protecting Taiwan from the mainland. Congress quickly passed the TRA to provide a framework for substantive US-ROC relations. But more importantly, the act leashed China from forcibly claiming Taiwan. This unique domestic legislation asserted that the US would “provide Taiwan with arms of a defensive character” and “to maintain the capacity of the United States to resist any resort to force or other forms of coercion that would jeopardize the security of the social or economic system of the people on Taiwan.” In the intervening 30 years, the United States has sold defensive weapons to the island to maintain the balance of power and have deployed US warships to keep the peace in the Taiwan Strait.

As the co-chair of the Congressional Taiwan Caucus and the chief sponsor of the 30th anniversary resolution, Representative Shelley Berkley said, “Taiwan is an inspiring story of expanding freedom, a robust capitalist economy and a strong trading partner of the United States.” While speaking on the House floor, she urged others to protect Taiwan. “We must do everything in our power to continue protecting it and ensuring its survival,” she said in the Taipei-based China Post.

Although many have criticized the TRA for being ambiguous and vague, the act has withstood the test of time by keeping a lid on simmering tensions across the Taiwan Strait. By pledging defensive support for Taiwan, the TRA has given the island the stability to develop from an authoritarian, agricultural society to an affluent democratic country. In the last 30 years, Taiwan’s per capita gross domestic product has jumped from US$1,957 in 1979 to US$17,116 in 2008. This arrangement has not only benefited Taiwan, but also the United States. In the last year alone, trade between Taiwan and the US totaled US$57.1 billion, making the island the 10th-largest trading partner of the US.

In place of an embassy and consulates, the TRA allowed the promotion of bi-lateral relations by setting up the American Institute in Taiwan (AIT) and the Taipei Economic and Cultural Representative Office (TECRO) in the United States. These two entities have worked “to maintain peace, security, and stability in the Western Pacific” and to continue the “commercial, cultural, and other relations between the people of the United States and the people on Taiwan.” Despite the pitfalls, the TRA has provided US-Taiwan relations with a sense of normality.

Much has been said about the Taiwan Relations Act’s vagueness, and many groups have lobbied to strengthen or weaken the act. Although the TRA asserted that “nothing in this act may be construed as a basis for supporting the exclusion or expulsion of Taiwan from continued membership in any international financial institution or any other international organization,” Taiwan has met with limited success in participating in international organizations. The island finally gained membership in the World Trade Organization (WTO), but is still excluded from the United Nations (UN) and the World Health Organization (WHO). For the last 10 years, the government in Taipei has pushed heavily for the island’s inclusion in the WHO and the UN. At the same time, China has mustered its substantial influence to counter Taiwan.

Under President Ma Ying-jeou’s administration, the government has sought to upgrade Taiwan’s relations with free trade agreements (FTA), visa-free entries and bilateral extraction treaties. Yet, Taiwan has no FTA with the United States or China, leaving the island’s export-oriented economy at a significant disadvantage. Unlike the independence-focused Democratic Progressive Party (DPP), Ma’s Kuomintang Party (KMT) sees Taiwan’s success closely tied to the mainland. As such, Ma has worked to complete the three-links (air, sea and mail) and to foster closer ties with Beijing.

Taiwan’s improved relations with China are reassuring to the United States, which often finds itself refereeing cross-strait conflicts. According to the Central News Agency, AIT Chairman Raymond Burghardt finds this era of cross-strait stability “very favorable to U.S. interests.” The diffused tension has allowed greater cooperation and opportunities for the people on both sides. In a recent meeting with Burghardt at the presidential office, Ma said, “I hope these positive developments will continue and that they will eventually benefit Taiwan, China and the United States.”

Ma considers meeting Premier Wen after “substantial issues” are settled

President Ma Ying-jeou has said that he may consider a meeting with Chinese Premier Wen Jiabao once the Economic Cooperation Framework Agreement (ECFA) is signed between Taiwan and China. Ma’s remarks came on March 20th, after having heard that Premier Wen would like to visit Taiwan, despite being elderly and weak.

According to the Taipei-based China Times, the president believes it is better for leaders of the two sides of the Taiwan Strait to meet after the “substantial issues” have been settled, referring to the ECFA. Ma’s willingness to visit China signals a change from his earlier campaign pledge – when he said he would not meet with Beijing’s leaders. “What is important is the timing. The meeting will be much more meaningful after the substantial issues are resolved,” Ma said.

Premier Wen said China is ready to tackle the ECFA with Taiwan, but the ruling government of the Nationalist Party (KMT) is dithering due to the opposition of the Democratic Progressive Party (DPP). However, without the ECFA, the Ma administration worries Taiwan will be excluded from the free trade accords taking place as part of Asian regional economic integration among the ten-member Association of Southeast Asian Nations (ASEAN) Plus One (China) and ASEAN Plus Three (China, Japan and South Korea) that go into effect in 2010 and 2015 respectively. The exclusion could cost the island over 110,000 jobs and reduce GDP growth by 1 percent. Due to a lack of diplomatic ties, ASEAN members and other countries are reluctant to sign free trade agreements (FTA) with Taiwan unless the two sides of the Taiwan Strait reach a similar pact first.

Hoping such an agreement might be signed by the end of this year, Ma has instructed P. K. Chiang, chairman of the Straits Exchange Foundation (SEF), to talk about the possibility of signing the ECFA with his Chinese counterpart Chen Yunlin. The next Chiang-Chen meeting is reported to be in Nanking (China) at the end of April. According to the China Times, the “substantial issues,” such as the removal of tariff and non-tariff barriers, protection of Taiwanese investors in China, opening up of trade in petrochemical, machinery and textile products, and protection of intellectual property rights (IPR), are expected to be discussed in another round of Chiang-Chen meeting in Taipei by the end of this year.

Another benefit of the improved relations between Taipei and Beijing has been the increased numbers of mainland Chinese tourists visiting Taiwan, now averaging 2,000 daily. The Liberty Times reported, 330,000 mainland Chinese visited Taiwan last year, while 3.8 million Taiwanese visited China. Ma said that Wen’s desire to visit Taiwan would only encourage more mainlanders to visit Taiwan.

Ma: Taiwan focuses on six core industries

On March 25th, President Ma Ying-jeou again reiterated his intention to promote biotechnology, green energy, tourism, healthcare, cultural innovation and refined agriculture as Taiwan’s new star industries. He said these six core industries would become the central economic drivers of Taiwan, allowing the island’s people to maintain their high living standards.

Already, Taiwan’s government has responded with the “biotechnology takeoff package,” setting forth an ambitious set of goals aimed at reinvigorating the island’s biotechnology industries. The government projects that the sector will have an annual production value of over US$29.5 billion within 10 years.

In order to stimulate the industry, the government plans to set up a US$1.8 billion biotechnology venture capital fund, with 40 percent of the capital coming from the government’s National Development Fund and the remaining 60 percent from the private sector. A portion of the funds will go towards the cost of opening new biotechnology parks to help kick-start new domestic and foreign biotechnology ventures.

In addition, the government intends to establish a food and drug administration similar to the regulatory body found in the United States. By bringing Taiwan’s pharmaceutical products up to international standards, the government hopes to raise the industry’s profile and increase its market share. In 2007, the pharmaceutics and medical equipment markets accounted for US$194 billion and US$714 billion, respectively.

As well as developing the six core industries, Ma emphasized the importance of pursuing a higher quality of life for the island’s people through innovation and creativity, and not simply by revamping older industries. A Ministry of Economic Affairs (MOEA) statement added that the island’s manufacturing industries need to place a greater emphasis on “efficiency” and “effectiveness,” hinting that lower-end semiconductor companies should be relocated from the Hsinchu and Tainan Science Parks to China or other countries. This would free up much needed capacity for the manufacture of more advanced 12-inch or 18-inch wafers.

Since Ma set out his pledge to focus on these six core industries after meeting with Taiwan’s financial and economic chiefs on February 21st, the MOEA has been formulating a stimulus package with this in mind. According to the Central News Agency, the president said, “We agreed that the government should support these industries as a means of pushing Taiwan to gain an advantage in the global industrial realignment that will occur when the worldwide economic crisis comes to an end.” By instructing his administration to develop these six sectors, Ma has set forth an ambitious road map for Taiwan’s future – one that he hopes will help the island recover more quickly.

Taiwan plans to lift ban on Chinese investments

The Taiwan government is planning to lift a ban on Chinese investment in Taiwan. Under the draft proposal, a company with Chinese ownership of less than 50 percent would be allowed to invest directly in Taiwan similarly to any other foreign investor. Above that level, the company would be considered a Chinese owned company and would be subjected to greater restrictions, the Apple Daily reported.

Even wholly owned Chinese companies would be allowed to invest in certain Taiwanese industries or in joint-venture partnerships with a Taiwanese company. An Economics Ministry official quoted in the Apple Daily noted that “after the proposed relaxation, even Chinese national enterprises can invest in Taiwan.” Chinese investment in industries such as solar energy, automobiles and wind power will be welcomed.

Due to national security concerns, mainland companies will not be able to invest in Taiwan’s national defense, certain monopoly businesses or sensitive high-tech areas. Restrictions will also apply to the financial and telecommunications sectors because of the need to modify laws and regulations, and the complicated review process among government agencies.

Business leaders and academics welcome the plan, saying that the two sides should engage in mutual investment now that relations across the Taiwan Strait have thawed somewhat. Cross-strait investments will be one of the main topics on the table when the Straits Exchange Foundation (SEF) and the Association for Relations Across the Taiwan Strait (ARATS), that represent Taiwan and China respectively, meet in Nanking (China) at the end of April.

Taiwan issues casino licenses amid protests

In March, Taiwan issued two gambling resort licenses to AMZ Holdings Plc and to Taiwan’s Penghu Bay Development Company. These were the first licenses granted since the government lifted the decade-long ban on gambling in January. Both companies have already been moving ahead with site preparation on Penghu Island, the largest offshore island off Taiwan.

The Taipei-based China Times reported that the companies granted licenses would have to commit to building a resort with at least 1000 rooms. However, the biggest hurdle might not be building such a large resort, but rather, in getting local approval to build the casinos in the first place. Although the government has now legalized casinos, the developers can only proceed with the construction if they also gain the approval of the local residents in a referendum. Approval might prove difficult given the emerging local opposition to the plans.

Worrying that the casinos will increase crime and create moral degeneration on the islands, hundreds of demonstrators from religious and environmental protection groups took to the streets in Taipei to vent their opposition. According to the Taiwan News, protesters fear that gambling would cause more drug addiction, debt, social problems and family conflicts, while the casinos might “attract gangsters and prostitutes.”

Although the offshore islands of Kinmen, Matsu, Penghu, Liuchiu, Green Island (Lutao) and Orchid Island (Lanyu) qualify for casinos, the government is not planning to issue any more licenses in the next 10 years. It hopes this will limit competition and minimize possible negative social impacts. Penghu hopes to attract half a million visitors a year, generating US$3 billion worth of revenue annually in gambling and tourism, and creating up to 50,000 jobs. If approved by the local community, the casino resorts are expected to open in 2013.