#  Designing Taiwan’s National Health System 

 





June 29, 2023

 

 

     ![William Hsiao.](/sites/g/files/omnuum10866/files/styles/hwp_16_9__480x270/public/2025-09/20230316_GLS_BHsiao-UHC-int_002.jpg?itok=EXyjNjt7) 

 



 

 In February, [Professor William Hsiao](/people/william-hsiao), Senior Faculty Scholar at the Global Health Education and Leaning Incubator, was interviewed by a Taiwanese film crew for a documentary on Taiwan’s national health system. Hsiao, the K.T. Li Professor of Economics, Emeritus, at the Harvard T.H. Chan School of Public Health, is a leading global expert in universal health insurance, which he has studied for more than forty years.

 The documentary, which will air in both Chinese and English, will cover the history of Taiwan’s national health system, widely regarded as one of the most successful health systems in the world. Hsiao will be featured in the documentary, discussing his contribution as the leader of the task force that designed the system. Hsiao is a leading expert on universal health insurance and has worked in health system reform for over twenty countries, including Taiwan.

 Taiwan’s national health insurance program is a single-payer system that covers 99 percent of residents, including visitors who stay in Taiwan for more than three months. The program covers a comprehensive range of services at low and subsidized costs, and it has enjoyed consistently high approval ratings since it was implemented in 1995.

 In a video interview with the Incubator, Hsiao tells the story of how he was invited to lead the team designing this system in 1989. At the time, Taiwan had seen a period of rapid economic growth and wanted to update its health system to match. The task force was given three goals to fulfill in designing this new system: there needed to be universal coverage for comprehensive care distributed on an equal basis; it had to be affordable and therefore efficient; and it had to be sustainable to control the cost of health care in the future.



 

 In pursuit of these three goals, the task force first had to understand the context in which they were working in.

 “What was most important for me, was that one, I had to understand Taiwan’s society: its people, its history, its culture, and also the economic and social conditions of Taiwan at that time,” said Hsiao. “What can Taiwan afford, for example. And how many people are still working on farms? How many people are employed by industries? What are the disease patterns? How good is the water and sewage system?”

 Understanding Taiwan’s current and historical context was important to figuring out what Taiwan needed and wanted its health system to do. Once they understood Taiwan’s situation, the task force then analyzed where health systems in other countries succeeded and adapted those strategies to fit Taiwan’s needs. “We did not pretend we had all the answers in our heads. We were trying to learn from other countries,” said Hsiao.

 That’s an area Hsiao believes the United States can learn from. In a [2019](https://www.foreignaffairs.com/articles/united-states/2019-12-10/how-fix-american-health-care) article published in *Foreign Affairs*, Hsiao discusses how Canada, Taiwan, and Germany can serve as models for how the U.S. can fix its health system. Though Taiwan still faces its own challenges, learning from the successes and failures of other countries is what allowed Taiwan to build a model that is so highly regarded by its people and by experts around the world.

 To learn more about designing Taiwan’s health system, watch the Incubator’s [full interview with Professor Hsiao](https://vimeo.com/815498263/3476b9215e). For additional information on how country-specific strategies have contributed to health system success, explore our resource pack on [country cases of health reform](https://repository.gheli.harvard.edu/repository/collection/resource-pack-country-cases-of-health-reform/).



 

 

 



 

 

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