the NHI. Early in the program, the payment system was predominantly fee-for-service. Most health providers operate in the private sector and form a competitive market on the health delivery side. However, many healthcare providers took advantage of the system by offering unnecessary services to a larger number of patients and then billing the government. In the face of increasing loss and the need for cost containment, NHI changed the payment system from fee-for-service to a global budget, a kind of prospective payment system, in 2002. The implementation of universal healthcare created fewer health disparities for lower-income citizens in Taiwan. According to a recently published survey, out of 3,360 patients surveyed at a randomly chosen hospital, 75.1 per cent of the patients said they are "very satisfied" with the hospital service; 20.5 per cent said they are "okay" with the service. Only 4.4 per cent of the patients said they are either "not satisfied" or "very not satisfied" with the service or care provided. The Taiwanese disease control authority is the Taiwan Centers for Disease Control (CDC), and during the SARS outbreak in March 2003 there were 347 confirmed cases. During the outbreak the CDC and local governments set up monitoring stations throughout public transportation, recreational sites and other public areas. With full containment in July 2003, there has not been a case of SARS since. Owing to the lessons from SARS, a was established in 2004, which includes the Central Epidemic Command Center (CECC). The CECC has since played a central role in Taiwan's approach to epidemics, including the COVID-19 pandemic. In 2019, the infant mortality rate was 4.2 deaths per 1,000 live births, with 20 physicians and 71 hospital beds per 10,000 people. Life expectancy at birth in 2020 is 77.5 years and 83.9 years for males and females, respectively. Culture The cultures of Taiwan are a hybrid blend from various sources, incorporating elements of the majority traditional Chinese culture, aboriginal cultures, Japanese cultural influence, traditional Confucianist beliefs, and increasingly, Western values. During the martial law period in which the Republic of China was officially anti-communist, the Kuomintang promoted an official traditional Chinese culture over Taiwan in order to emphasize that the Republic of China represents the true orthodoxy to Chinese Culture (and therefore the "real and legitimate China") as opposed to Communist China. The government launched what's known as the Chinese Cultural Renaissance movement in Taiwan in opposition