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Gifts, bribes and solicitions: Print media and the social construction of informal payments to doctors in Taiwan

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  • Chiu, Yu-Chan
  • Smith, Katherine Clegg
  • Morlock, Laura
  • Wissow, Lawrence

Abstract

The Taiwanese practice of patients giving informal payments to physicians to secure services is deeply rooted in social and cultural factors. This study examines the portrayal of informal payments by Taiwanese print news media over a period of 12 years--from prior to until after the implementation of national health insurance (NHI) in Taiwan in 1995. The goal of the study was to examine how the advent of NHI changed the rationale for and use of informal payments. Both before and after the introduction of NHI, Taiwanese newspapers portrayed informal payments as appropriate means to secure access to better health care. Newspaper accounts established that, although NHI reduced patients' financial barriers to care, it did not change deeply held cultural beliefs that good care depended on the development of a reciprocal sense of obligation between patients and physicians. Physicians may have also encouraged the ongoing use of informal payments to make up revenue lost when NHI standardized fees and limited income from dispensing medications. In 2002, seven years after the implementation of NHI, the use of informal payments, though illegal, was still being justified in the print media through allusions to its role in traditional Taiwanese culture.

Suggested Citation

  • Chiu, Yu-Chan & Smith, Katherine Clegg & Morlock, Laura & Wissow, Lawrence, 2007. "Gifts, bribes and solicitions: Print media and the social construction of informal payments to doctors in Taiwan," Social Science & Medicine, Elsevier, vol. 64(3), pages 521-530, February.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:3:p:521-530
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    References listed on IDEAS

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    1. Minoo Alipouri Sakha & Telma Zahirian Moghadam & Hassan Ghobadi & Hamed Zandian, 2020. "Exploring the changes of physicians' behaviour toward informal payment based on Health Transformation Plan in Iran: A qualitative study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1127-1139, September.
    2. Bardey, David & Li, Sanxi & Wu, Yaping, 2015. "Health Care Insurance Payment Policy when the Physician and Patient May Collude," TSE Working Papers 15-572, Toulouse School of Economics (TSE).
    3. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    4. Chiu, Yu-Chan, 2010. "What drives patients to sue doctors? The role of cultural factors in the pursuit of malpractice claims in Taiwan," Social Science & Medicine, Elsevier, vol. 71(4), pages 702-707, August.
    5. Onwujekwe, Obinna & Dike, Nkem & Uzochukwu, Benjamin & Ezeoke, Ogochukwu, 2010. "Informal payments for healthcare: Differences in expenditures from consumers and providers perspectives for treatment of malaria in Nigeria," Health Policy, Elsevier, vol. 96(1), pages 72-79, June.
    6. Vuong, Quan-Hoang & La, Viet-Phuong & Le, Tam-Tri & Hoang, Giang & Jin, Ruining & Quang-Loc, Nguyen & Vuong, Thu-Trang & Nguyen, Minh-Hoang, 2023. "Envelope culture in the healthcare system: happy poison for the vulnerable," OSF Preprints 4fwj9, Center for Open Science.
    7. Williams, Colin C. & Horodnic, Adrian V., 2017. "Rethinking informal payments by patients in Europe: An institutional approach," Health Policy, Elsevier, vol. 121(10), pages 1053-1062.

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