Does universal health insurance make health care unaffordable? Lessons from Taiwan

Health Aff (Millwood). 2003 May-Jun;22(3):77-88. doi: 10.1377/hlthaff.22.3.77.


This paper examines the performance of Taiwan's National Health Insurance (NHI), a universal health insurance program, implemented in 1995, that covers comprehensive services. The authors address two key questions: Did the NHI cause Taiwanese health spending to escalate to an "unaffordable" level? What are the benefits of the NHI? They find that Taiwan's single-payer NHI system enabled Taiwan to manage health spending inflation and that the resulting savings largely offset the incremental cost of covering the previously uninsured. Under the NHI, the Taiwanese have more equal access to health care, greater financial risk protection, and equity in health care financing. The NHI consistently receives a 70 percent public satisfaction rate.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Comprehensive Health Care / economics*
  • Consumer Behavior
  • Cost Control / methods
  • Health Expenditures / trends*
  • Health Services Accessibility
  • Health Services Research
  • Health Status Indicators
  • Humans
  • National Health Programs / organization & administration*
  • Program Evaluation
  • Quality of Health Care
  • Taiwan / epidemiology
  • Universal Health Insurance*