Abstract

Since its adoption, Taiwan’s NHI has achieved a low-cost, high-efficiency performance, with a satisfaction rate as high as 80 percent on average. However, the imbalance between expenditure and revenue has resulted in a cycle of unsustainable spending which also caused the subsequent necessary reforms and political confrontations in Taiwan. This paper aims to focus on three overlapping themes of the experience of Taiwan’s NHI financial sustainability: (1) the rationale and achievements of the programme so far, along with the growing pains it has encountered in financial sustainability; (2) the factors leading to the financial crisis and the major reform proposals since 1998; (3) the political obstructions, governance capability and government strategies to promote the NHI reform. Obviously, the issue of the financial sustainability of the healthcare operation is always unfinished business. It can be anticipated that the lesson from Taiwan’s experience will provide an interesting comparison to other traditional and renowned welfare systems around the world.

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