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Taiwan’s inclusion of prison inmates into the National Health Insurance healthcare system received the praise from experts at the World Health Assembly yesterday, becoming a role model for other counties.

  • Data Source:Ministry of Health and Welfare
  • Created:2014-05-24
  • Last Updated:2017-02-03

On January 1, 2013, 65,000 inmates were included into the National Health Insurance (NHI) healthcare system in Taiwan, allowing these inmates to share Taiwan’s healthcare benefits with the general public. This arrangement received considerable praise both domestically and internationally. Prof. Hernan Reyes, senior researcher at the Human Rights Center of the University of California, Berkeley, praised Taiwan for this arrangement at the World Health Assembly (WHA) yesterday. In addition, Prof. Andrew Coyle of King’s College London in the United Kingdom repeatedly praised Taiwan for demonstrating exceptionally humane prison management during his visit to the Tainan Prison, stating that prison management in Taiwan is an example that other countries should follow. 
“Universal Healthcare Coverage” was the theme of last year’s WHA. This year, the 67th WHA was held in Geneva, Switzerland, where delegates sequentially spoke in front of the entire assembly and two technical committees (A and B) to share their efforts in enhancing the universal healthcare coverage in their respective countries throughout the year. Representatives from Taiwan shared their efforts to introduce prison inmates into the NHI healthcare system from January 1 last year, gaining considerable attention from numerous countries. 
Mr. Yi-Ming Pang, Director of the Southern Operations Division, National Health Insurance Administration, Ministry of Health and Welfare, explained that Prof. Reyes maintains a lifelong belief that “countries without prison health do not have public health.” Thus, Prof. Reyes has traveled to over 90 countries, and visited prisons in over 50, to understand how inmates are treated and to put forward timely suggestions. 
Prof. Reyes believes that prisons are zones of dense population, where people are at increased risk of contracting infectious diseases such as tuberculosis. If appropriate health management is not provided to inmates, these diseases will spread across the entire community, causing unthinkable disaster. On learning that Taiwan has already included inmates into its NHI healthcare system, he repeatedly complemented Taiwan for this arrangement, and regarded Taiwan as a role model for other countries. 
Mr. Pang further reported that Prof. Coyle of King’s College London and Prof. Josiah Rich of Brown University in the United States visited Taiwan under the invitation of Prof. Xiao-Ping Chen of the National Chung Cheng University. The group visited the Tainan Prison, located in the Guiren District of Tainan City, to obtain an on-site perspective on inmates’ health conditions yesterday. Having served as a prison warden for over 30 years, Prof. Coyle revealed to the accompanying committee member of the Southern Operations Division of the National Health Insurance Administration, Ms. Chun-Mei Lin, that the health of inmates were well taken care of just by smelling the odorless environment of Tainan Prison. 
Prof. Chen asserted that we have introduced prison inmates into the NHI healthcare system since last year, which is an achievement of which Taiwan is extremely proud. In fact, this inclusion not only enhances the universal value of human rights, but also has its pragmatic meaning, as it effectively and economically preserves the healthcare rights of inmates. 
As stipulated in Paragraph 1, Article 10 of the UN’s International Covenant on Civil and Political Rights, all persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person. In addition, Paragraph 1, Article 12 of the UN’s International Covenant on Economic, Social and Cultural Rights stipulates that the states parties to the present covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Based on these important international covenants, the World Health Organization (WHO) emphasizes that although the freedom of inmates is restricted, their healthcare rights should be perceived equal to those of the general public. Moreover, healthcare staff serving in prisons should be independent from the prison administration system; maintain a purpose of providing healthcare, not punishment, to inmates; and implement preventive care and uphold general medical ethics. 
Prof. Chen further asserted that Prof. Coyle is an internationally renowned prison health expert. His signature work, A Human Rights Approach to Prison Management: Handbook for Prison Staff, is translated into numerous languages and valued all over the world. He fundamentally advocates that in any democratic society, the imposition of imprisonment should always be an instrument of last resort; prisons are a part of the civil society and must be monitored with democratic mechanisms; the country has an inevitable responsibility toward the healthcare of inmates; and inmates, prison staff, and visitors should be treated with similar dignity and respect. 
Prof. Rich explained that because of the severe degradation of social, religious, and educational functions, the United States has become a country with the most imprisonments in the world. With a global population size of only 5%, the inmates imprisoned in the United States occupy approximately a quarter of all inmates in the world. These inmates often do not receive appropriate treatment and health education during their sentence, and consequently become a burden to the country with the diseases they contract when they are released. Therefore, appropriate medical care and health education in prisons has become a focal issue in the field of public health. 
Mr. Pang expressed that the healthcare standards for inmates are the same as those for the general public in Taiwan. However, because of their freedom limitations, outpatient units are established within the prisons to provide healthcare services. If the limited medical equipment and staff cannot satisfy inmates’ medical needs, they are referred to external medical institutions for treatment. 
The yearlong implementation of this policy has received the general acceptance of the inmates, achieving an overall satisfactory rating of over 90%. The NHI provides over 2100 counts of outpatient services to various correctional institutions, such as prisons, each month. These services range across 28 specializations of western medicine, dentistry, and Chinese medicine, among others. On average, over 56,000 inmates receive clinical care, and more than 400 inmates are hospitalized each month. Roughly NT$800 million is paid out in NHI healthcare expenditures for inmates each year.