IDEAS home Printed from
   My bibliography  Save this article

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


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


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

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Lupton, Deborah & McLean, Jane, 1998. "Representing doctors: discourses and images in the Australian press," Social Science & Medicine, Elsevier, vol. 46(8), pages 947-958, April.
    2. Mukesh Chawla & Peter Berman & Dorota Kawiorska, 1998. "Financing health services in Poland: new evidence on private expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 337-346, June.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. 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).
    2. 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.
    3. 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.
    4. 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.
    5. 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.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:64:y:2007:i:3:p:521-530. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Haili He). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.