| Summary: | 碩士 === 國立成功大學 === 政治經濟學研究所 === 101 === Since the KMT government arrived in Taiwan, Taiwan has developed a public health system. Taiwan’s earliest public health institution initiated in the 1950’s by labor insurance. This was followed by army insurance, government employees’ and school staffs’ insurance, retirees insurance, private school staffs’ insurance and farmer’s health insurance. Taiwan’s National health insurance was implemented on March 1st 1995, marking a new milestone for Taiwan’s health insurance.
Taiwan's health insurance system developed very early, but owing to a lack of planning prior to implementation, there were over 14 different insurance systems. Over time these systems merged and brought into existence the National Health Insurance. Taiwan’s health insurance policies have varied over time, witnessing the development of different standards of rates and benefits. This has made it difficult to develop a unified and fair insurance system.
This research uses induced change and imposed change models of institutional change to analyze the theoretical foundation of the evolution of public health insurance institutions in Taiwan. It analyzes the process of institutional change in Taiwan’s public health insurance, looking at the influence of resource endowments, culture endowments, technology and national power on health insurance institutions. It analyzes public health systems in different time periods and classifies them under models of induced change and imposed change.
This paper compares labor insurance, government employees’ insurance, farmer’s health insurance, and National Health Insurance. It is based on the historical institutional and data analysis methods. This paper finds that prior to lifting martial law, changes to Taiwan’s public health institutions were mandatory owing to the use of national power, while after martial law was lifted, it changed to a model of government-led induced institutional change. By observing the Taiwan’s public health insurance over time, it can be seen that national power played a key role in its development. It is obvious that this development has been influenced by politics. This paper anticipates that national power and culture endowments will have a weak impact on Taiwan’s future national health insurance, while resource endowments and technology will have a positive influence.
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