As a scholar expert in both Taiwan's National Health Insurance Act (NHI Act) and Vietnam's Health Insurance Law (HIL), I'd be delighted to highlight the differences between the two laws.
1.Funding Mechanism: Taiwan's NHI Act is a single-payer system, where premiums are collected from citizens and employers, and the government provides subsidies to cover the costs. In contrast, Vietnam's HIL is a mixed system, where there are three main funding sources: individual premium payments, government subsidies, and other revenue sources (such as taxes and donations).
2.Eligibility: Both laws cover all citizens, but Vietnam's HIL has a more extensive list of benefits for vulnerable groups, such as children, the elderly, and people with disabilities.
3.Coverage Scope: Taiwan's NHI Act provides comprehensive coverage, including outpatient services, hospital stays, medical equipment, and therapies. Vietnam's HIL also covers a broad range of services, with a greater emphasis on preventive care and community-based services.
4.Co-Payment: Taiwan's NHI Act has a co-payment system, where patients pay a percentage of the medical bill (typically 10-20%). Vietnam's HIL has a different co-payment structure, with lower rates for vulnerable groups and a mandatory 10% co-payment for most services.
5.Claim Review and Appeals: Taiwan's NHI Act has a more rigorous claim review process, with a two-tiered system: (1) initial review by the insurance company, and (2) appeal to the Review Committee. Vietnam's HIL has a single-tier review process, with a focus on resolving disputes through administrative channels.
6.Medical Professional Regulation: Taiwan's NHI Act requires medical professionals to register and obtain licenses to practice, while Vietnam's HIL requires them to obtain certification and registration with the Ministry of Health.
7.Free Choice of Provider: Taiwan's NHI Act allows patients to choose their healthcare provider, while Vietnam's HIL has a primary care system, where patients are assigned a designated provider.
8.Patient Protection: Taiwan's NHI Act has a stronger patient protection framework, with provisions for patient rights, informed consent, and confidentiality. Vietnam's HIL has similar provisions, but they are not as robust.
9.Administrative Structure: Taiwan's NHI Act is administered by the Bureau of National Health Insurance (BNHI) under the Ministry of Health and Welfare. Vietnam's HIL is administered by the Ministry of Health, with the support of other government agencies and the Vietnam Social Security (VSS) fund.
10.Denial of Service: Taiwan's NHI Act has clear guidelines for denying service, which are based on medical necessity and evidence-based medicine. Vietnam's HIL also has guidelines for denying service, but they are not as detailed.
In summary, while both laws share similar goals and objectives, there are significant differences in their funding mechanisms, coverage scope, co-payment structures, and administrative structures. Taiwan's NHI Act is considered a more comprehensive and patient-centered system, while Vietnam's HIL is still evolving and refining its system.
身為台灣《全民健康保險法》（NHI Act）和越南《健康保險法》（HIL）的學者專家，我很高興強調這兩個法律之間的差異。
1.資金機制：台灣的國民健康保險法是單一支付者制度，保費向公民和雇主收取，政府提供補貼以支付費用。 相較之下，越南的HIL是一個混合系統，其資金來源主要有三：個人保費繳納、政府補貼和其他收入來源（如稅收和捐贈）。
2.資格：兩項法律都涵蓋所有公民，但越南的 HIL 為弱勢群體（例如兒童、老年人和殘疾人）提供了更廣泛的福利清單。
3.保障範圍：台灣國民健康保險法提供全面保障，包括門診、住院、醫療設備、治療等。 越南的 HIL 也涵蓋廣泛的服務，更注重預防性護理和社區服務。
4.自付額：台灣的國民健康保險法案有自付額制度，病人支付一定比例的醫療費用（通常為10-20%）。 越南的 HIL 具有不同的自付費用結構，弱勢群體的費率較低，且大多數服務強制支付 10% 的自付費用。
5.理賠審查與上訴：台灣國民健康保險法有更嚴格的理賠審查流程，分為兩級制度：（1）保險公司初審，（2）向審查委員會提出上訴。 越南的 HIL 採用單層審查流程，重點在於透過行政管道解決爭議。
6.醫療專業法規：台灣的NHI法案要求醫療專業人員註冊並獲得執業許可證，而越南的HIL則要求他們獲得衛生部的認證和註冊。
7.自由選擇提供者：台灣的國民健康保險法案允許患者選擇他們的醫療保健提供者，而越南的 HIL 擁有初級保健系統，為患者分配指定的提供者。
8.病患保護：台灣的國民健康保險法案擁有更強大的病患保護框架，包含病患權利、知情同意和保密等條款。 越南的 HIL 也有類似的規定，但沒有那麼嚴格。
9.行政架構：台灣的國民健康保險法由衛生福利部國民健康保險局（BNHI）負責管理。 越南的 HIL 由衛生部管理，並得到其他政府機構和越南社會保障 (VSS) 基金的支持。
10.拒絕服務：台灣的國民健康保險法案對拒絕服務有明確的指導方針，這些指導方針基於醫療必要性和循證醫學。 越南的 HIL 也有拒絕服務的指南，但沒有那麼詳細。
總之，雖然兩部法律有著相似的目的和目標，但其資助機制、覆蓋範圍、共同支付結構和管理結構有顯著差異。 台灣的 NHI 法案被認為是一個更全面、以病人為中心的體系，而越南的 HIL 仍在發展和完善其體系。