「高效率、低成本」的台灣的醫療體系

2025-06-27

台灣的醫療體系被國際譽為「高效率、低成本」的典範,多數民眾因全民健保制度而能以極低的負擔享有優質醫療服務。住院期間的醫藥費與伙食費,通常等到出院時一次結清即可,不需預繳昂貴的押金,也無需擔心突如其來的高額帳單。絕大多數醫療項目均有健保給付,病患僅需負擔少部分自費,費用透明合理,因此多數人即使罹患重大疾病,也不會因醫療費用而傾家蕩產。

在急診資源方面,台灣的各大醫院普遍設有24小時營運的急診室,不論白天黑夜都能即時收治病人;病床資源充足,病患入院通常無需長時間等待。而門診方面,透過網路或電話預約制度,即使是大型醫學中心,民眾也能在幾天內順利掛號,流程順暢,效率高,醫師輪班與服務也相當完整。

相較之下,中國大陸的醫療體系呈現出截然不同的樣貌。首先,醫療資源分布極度不均。頂尖的三甲醫院集中於一線城市,導致大量病人跨省湧入北京、上海、廣州等地就醫,使得當地醫院常年處於超負荷運轉狀態。為了掛號,病患清晨排隊、甚至透過「黃牛」購買號碼的情況仍時有所聞。普通民眾若無人脈或特別關係,常常難以在短時間內見到知名專科醫師。

在費用方面,中國雖有實施基本醫保制度,但由於報銷比例與範圍有限,加上許多進口藥物、高階檢查與手術項目不在保險範圍內,導致不少家庭面臨沉重的醫療開銷,尤其是重大疾病或罕見病時尤為明顯。此外,部分醫療機構存在自費藥品推薦或不必要檢查的情況,導致醫療信任度時常受質疑。

行政流程也是兩地的明顯差異。台灣就醫時,病人持健保卡即可完成掛號、看診、繳費、領藥的全套流程,大多不需等待過久,並能即時獲得詳細的病歷說明與用藥指引。而在中國,多數公立醫院流程繁瑣,從掛號、候診、檢查、領藥到繳費各環節常須排隊數次,病患在醫院奔波的情況頗為常見。

總體而言,台灣的醫療體系以高覆蓋率、低門檻、就醫便利與費用可負擔為特徵,是建立在全民健保制度與醫療資源公平分配的基礎上;而中國大陸則仍處於醫療資源集中化、民間負擔重、系統效率與信任機制尚待完善的階段。這些差異不僅反映出政策設計的不同,也深刻影響兩地民眾的醫療體驗與健康安全感。

Taiwan's healthcare system has been internationally recognized as a model of high efficiency and low cost. Thanks to its National Health Insurance (NHI) program, the majority of citizens enjoy access to high-quality medical services with minimal financial burden. Hospitalization fees, including medical expenses and meals, are typically settled in one payment upon discharge, with no need for large upfront deposits or worries about unexpected, overwhelming bills. Most medical services are covered by NHI, leaving patients to pay only a small out-of-pocket portion. With transparent and reasonable pricing, even those diagnosed with serious illnesses rarely face financial ruin due to medical costs.

In terms of emergency care, major hospitals across Taiwan operate 24-hour emergency departments, ensuring that patients can receive prompt treatment at any time of day. Hospital bed availability is generally sufficient, minimizing waiting times for admissions. For outpatient services, appointments can be easily made via phone or online booking systems. Even in large medical centers, patients can typically see a doctor within a few days. The process is streamlined and efficient, with well-organized medical staff rotations and comprehensive service coverage.

In contrast, the healthcare system in mainland China presents a very different picture. One of the most notable challenges is the extreme imbalance in resource distribution. Top-tier Class A hospitals (known as "3A hospitals") are concentrated in major metropolitan areas such as Beijing, Shanghai, and Guangzhou. This has led to a surge of patients traveling across provinces to seek care in these cities, placing immense strain on hospital capacity and resulting in long-term overcrowding. It is not uncommon for patients to queue early in the morning or rely on ticket scalpers to secure appointments. Without personal connections or special access, it can be very difficult for ordinary citizens to consult with renowned specialists promptly.

 

Regarding medical expenses, although China has a basic medical insurance system in place, its reimbursement rates and coverage remain limited. Many imported medications, advanced diagnostics, and surgical procedures are excluded from insurance coverage, leaving families to shoulder significant out-of-pocket costs—especially in the case of serious or rare diseases. Additionally, some institutions have been criticized for recommending out-of-pocket drugs or unnecessary procedures, which undermines public trust in the medical system.

The administrative process also highlights a major difference between the two systems. In Taiwan, patients simply present their NHI card to complete registration, consultation, payment, and prescription pickup all in one streamlined process. Waiting times are usually short, and patients receive clear explanations of diagnoses and medications. In contrast, most public hospitals in China have complex and fragmented procedures. Patients often need to queue multiple times—once for registration, again for consultation, then for tests, payment, and finally to collect medications. As a result, it is common to see patients navigating the hospital system in a state of frustration and fatigue.

Overall, Taiwan’s healthcare system is characterized by high coverage, low barriers to access, convenience, and affordability, built on the foundation of universal health insurance and relatively equitable distribution of medical resources. On the other hand, mainland China’s system is still marked by centralized resources, heavy financial burdens on individuals, and systemic inefficiencies, with trust in medical institutions still developing. These differences not only reflect divergent policy frameworks but also deeply influence the healthcare experiences and sense of health security for people in both regions.