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Questions and Answers on Inclusion of Mainland Chinese Students in the Health Insurance System

January 2017

1.Why is the government promoting the inclusion of mainland Chinese Students in the Health Insurance System?

(1) Based on humanitarian considerations and a human rights perspective, the government decided to include mainland Chinese students studying in Taiwan in the national health insurance (NHI) system, comparable to the treatment of foreign and overseas Chinese students.

(2) The NHI program is rooted in the spirit that people residing long-term in the same land should mutually share medical risk through "self-help and mutual aid" to safeguard the health of all residents.

2.Once Mainland students studying for degrees in Taiwan are included in the national health insurance system, will this measure be expanded to include coverage of Mainland students in Taiwan for short-term studies?

(1) The government has promoted the inclusion of mainland Chinese students in the NHI system since 2012. According to the Regulations Regarding the People of the Mainland Area to Study in Taiwanese Institutions of Higher Education, the target beneficiaries are Mainland students in Taiwan for long-term degree studies.

(2) Mainland students visiting Taiwan for exchanges or short-term study according to the Regulations Governing the Entry Permission to the Taiwan Area for the People from Mainland China have different reasons for visiting and most stay for a short period of time (six months or less). Consequently, there are currently no plans to include such students in the NHI system. The feasibility of future inclusion in the NHI system of short-term students from the Mainland who extend their stay in Taiwan to more than six months will be carefully assessed with the competent authority, the Ministry of Education, in accordance with the principle of "phased implementation, review and amendment, and complete supporting measures," as well as in consideration of the overall status of the NHI system and views of various circles in society.

3.The Act Governing Relations between the People of the Taiwan Area and the Mainland Area currently regulates affairs related to contact between people on the two sides. Why not amend this act to include mainland Chinese students in the NHI system. What need is there to amend the National Health Insurance Act?

(1) The government advocates that mainland Chinese students should be included in the NHI system comparable to the treatment of foreign and overseas Chinese students and that they should self-pay the full premium. Since the National Health Insurance Act stipulates beneficiary "eligibility" and "premium" calculation, the government can review and adjust this Act.

(2) Article 1 of the Act Governing Relations between the People of the Taiwan Area and the Mainland Area stipulates that: "With regard to matters not provided for in this Act, the provisions of other relevant laws and regulations shall apply." This act is a principle-based set of rules for contact between the people of the two sides and is therefore unable to encompass all matters related to cross-Strait affairs. The latest statistics from the MAC indicate that, apart from this act, there are more than 53 laws and over 80 provisions regulating affairs related to contact between the people of the two sides.

(3) Therefore, stipulating rules in individual special laws that already regulate such matters would, from the perspective of integrity of legal application, help the competent authorities in their practical operations and business implementation

4.Under the NHI system, mainland Chinese students will need to pay premiums higher than those for private insurance. What good, then, is national health insurance?

Mainland students studying in Taiwan currently can be covered under student group insurance through their school. They can also get coverage under private group health insurance for overseas students. However, the benefits of private insurance coverage are far less than those provided by the NHI system. For example, private medical insurance is limited to NT$120,000 per in-patient hospital visit, while there is an upper daily limit of NT$1,000 in benefits for each outpatient (and emergency) care visit and hospital room fee. Insured persons with private coverage are required to first self-pay these fees and then provide related documents to request insurance benefits. The related benefits and coverage cannot compare to that of the National Health Insurance system.

5.Some people think that young people like Mainland students, are healthy and do not need health insurance. Do other countries require that students from overseas join the insurance system?

(1) The principle of universal health insurance is medical risk sharing among long-term residents of Taiwan. Therefore, Article 1 of the National Health Insurance Act stipulates that health insurance is compulsory social insurance. All non-Taiwan citizens eligible for inclusion in the NHI system "should" be included in the system. In the future, Mainland students eligible for inclusion in the NHI system should participate in the system as overseas Chinese and foreign students are now. Moreover, they should pay insurance premiums in accordance with relevant provisions of the National Health Insurance Act.

(2) Countries with a sound NHI system, such as the U.K.'s National Health Service (NHS) and Japan's National Health Insurance, all require foreign students studying in the country for six months or one year or more to share medical risk with the entire populace. In countries with primarily private health insurance, such as the United States, the government requires that foreign students have medical insurance as a condition of school registration.

6.The government promotes the inclusion of mainland Chinese students in the health insurance system, but the public believe that the "three restrictions and six noes" affecting the rights and interests of Mainland students should still be further relaxed. What is the MAC's view?

(1) The Ministry of Education, in conjunction with the relevant authorities, is actively reviewing relaxation of the "three restrictions and six noes" affecting Mainland students studying in Taiwan. Such measures include expanding recognition of Mainland academic credentials, increasing enrollment of Mainland students, allowing Mainland students to take skills certification examinations, allowing Mainland students to serve as research assistants related to their area of study, and continuing to streamline related entry and exit procedures. In the future, the government will continue to review measures related to Mainland students studying in Taiwan under the premise of not affecting the rights and interests of Taiwan students.

(2) Regarding problems potentially encountered by Mainland students in studying and living in Taiwan, the government has asked schools to set up dedicated units and strengthen counseling mechanisms to help Mainland students adapt to school life and the learning environment. It is also actively providing relevant facilitation measures, including: provision of private health insurance, permission to purchase cars (or motorcycles) and open bank or postal savings account, facilitation of visits by family members to Taiwan, and the streamlining of verification procedures for financial certification for entry to Taiwan. These measures aim to create a friendly study and living environment for Mainland students in Taiwan.