Topic: Health coverage: who's required to have it, and who actually pays
What does Taiwan require?
Everyday topic
Taiwan's National Health Insurance is mandatory social insurance under Article 1 of the National Health Insurance Act, launched 1 March 1995. Premiums combine a 5.17% general rate with a 2.11% supplementary premium; a regular employee's share splits employer 60%, insured person 30%, government 10%. Foreigners holding a residency document qualify for mandatory coverage once they've resided six months or are employed by a fixed employer (Article 9). Emergency co-pays scale by tier, from NT$750 at a medical center to NT$150 at a clinic. Enrollment reached roughly 99.9% in 2024 — the only single-payer system among the seven, run on one card that follows every patient's records nationwide.
What is this topic?
Taiwan's National Health Insurance Act declares enrollment mandatory in its very first article, launched in March 1995, with premiums split employer 60%, insured person 30%, government 10%.
Japan closed the last gap in "universal coverage" only in 1961, after a 1958 law forced every municipality to run its own scheme; patient co-payments still scale by age, from 10% at 75-plus to 30% between 6 and 69.
Indonesia's 2004 SJSN Law states outright that "participation is compulsory," and a foreign worker becomes covered after six months on the job — almost the same threshold Taiwan uses.
Brazil's SUS is the direct product of Article 196 of its 1988 Constitution, "health is a right of all and a duty of the State," free to anyone within its borders.
China, by contrast, reports 95% nominal coverage, but its employee and resident schemes reimburse hospital stays at rates 18 points apart — 84.1% versus 66.0%.
India has no universal mandate at all: PM-JAY reaches only the poorest 40% of households, and out-of-pocket spending still runs 43.4% of the total.
The United States is the only one of the seven with no coverage guarantee whatsoever — its federal mandate has existed in name only since 2019, 8.0% of the population remained uninsured in 2024, and it spends more per person on healthcare than any other.
Sources and dates
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