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Plans and Programs
The public health policies in the Taiwan area are mainly formulated
by the Department of Health 衛生署 (DOH). In fiscal 2000, three primary
plans and four secondary programs were drawn up under the directions
of the Executive Yuan and the Department of Health in order to improve
the health conditions of the people and the efficiency of the public
health care system. The plans and programs, respectively, to be
implemented according to schedule are as follows: the Management
Plan for the Control of Betel Nut Problem 檳榔問題管理方案, the Second Term
Reinforcement Plan for the Control of TB 加強結核病防治第三期計畫, the Three-year
Project for Long-term Care for the Old Age 老人長期照護三年計畫, the Second
Term Program for the Control of AIDS 後天免疫缺乏症候群第二期計畫, the Three-year
Project for Cancer Screening Community Service 癌症社區到點篩檢服務三年計畫, the
Three-year Project for the Development of Community Health Care
推動社區健康營造三年計畫, and the Human-used Vaccines Production Project 人用疫苗自製計畫. |
Shifting demographic patterns and changes in modern lifestyles have affected
health care in Taiwan. The graying of the population has highlighted pension
issues and long-term care for the elderly, and the influx of 316,076 foreign
laborers has exacerbated the problem of providing health care for foreign
workers. Serious pollution and smoking problems have triggered a high
rate of lung cancer, especially in the urban areas of Taipei, Kaohsiung,
Keelung 基隆, and Tainan. Industrial development and growth in urban traffic
have resulted in an alarming rate of occupational and traffic accidents.
Of the 12,960 fatal accidents recorded in 1999, 5,648 cases (or 43.58
percent) were transportation-related fatalities, constituting the leading
cause of death for people under the age of 44 in this category. More than
97 percent of the fatalities (5,526 persons) were due to motorbike-related
traffic accidents. A major youth health concern that has arisen is the
unprecedented number of students using amphetamines. Health authorities
are also concerned about the sanitation standards of Taiwan's many unregulated
eateries, roadside stalls, lunch box caterers, and galleries of food vendors.
Overall, the control of infectious diseases in the ROC has greatly improved.
Forty years ago, acute infectious diseases were the number one killer
in the Taiwan area; today they are no longer among the top ten causes
of death in Taiwan. Bubonic plague, smallpox, and cholera were all eradicated
long ago and not a single case of rabies has been discovered since 1959.
In 1965, the World Health Organization (WHO) of the United Nations declared
malaria nonexistent in Taiwan. Other infectious diseases such as diphtheria,
pertussis, neonatal tetanus, poliomyelitis, Japanese encephalitis, and
tuberculosis are now under strict control. Major immunization drives in
1995 focused on eradicating poliomyelitis, measles, congenital rubella,
and neonatal tetanus. In 1998, a pioneering plan was initiated that provided
free flu vaccinations to senior citizens 65 years or older.
The economic prosperity of the Taiwan area has brought greater access
to health care resources and enabled the government to launch the National
Health Insurance 全民健康保險 (NHI) program, which officially began on March
1, 1995. By December 1998, over 96 percent of the Taiwan population, or
20.76 million persons, were insured under the program.
The health situation in Taiwan has made impressive gains over the past
several decades. For example, average life expectancy from 1951 to 1999
has jumped from 53.38 years to 72.28 years for males, and from 56.33 years
to 77.97 years for females. The crude death rate dropped from 18.15 per
1,000 persons in 1947 to 5.73 per 1,000 persons in 1999, and the infant
mortality rate also dropped from 44.71 per 1,000 live births in 1952 to
a low of 4.80 per 1,000 in 1993. However, in 1996 infant mortality increased
to 6.66 mainly due to the implementation of a new, more efficient nationwide
registration system for reporting newborns. In 1999, the rate dropped
again to 6.07.
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