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March 8, 1995

Health System Reform in the Republic of ChinaFormulating Policy in a Market-Based Health System

Author Affiliations

From RAND Corporation, Santa Monica, Calif, and Department of Veterans Affairs, Department of Medicine, West Los Angeles, Calif (Dr Peabody); National Health Insurance Task Force, Taipei, Taiwan (Ms Yu and Ms Wang); and the University of California School of Public Health, Los Angeles, Calif (Dr Bickel). Ms Yu's current address is Winterthur, Republic Vanguard Life Insurance Co, Taipei, Taiwan.

JAMA. 1995;273(10):777-781. doi:10.1001/jama.1995.03520340033032

IN RECENT years, the Republic of China, often referred to as Taiwan, has been on a course similar in many ways to that of the United States as it has tried to navigate its way through health system reform. Like the United States, Taiwan's reform initiative began in response to two primary factors: access to care problems and rising costs of health services. Lack of health insurance for 46% of the population was another contributing cause. Government officials, facing social insurance plans with large deficits, and politicians using the issues of cost and access to appeal to the public, pushed reform efforts forward. Although important differences between the two countries exist, they share similar challenges of large-scale health system reform in market-based economies. Since Taiwan began its reform process in 1987, its experience previews the reform process and highlights another policy perspective for the United States.

Economic and Cultural Influences 

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