40 PERSPECTIVES ON BUSINESS AND ECONOMICS | VOL 43 | 2025 work, preventative care services, hospital discharge plans, and home-based medical care services (Chen & Fu, 2020). The changes from LTC 1.0 to LTC 2.0 reflect efforts to meet the diversity of aging needs in different communities and the accessibility of these services, emphasizing home- and community-based care. According to a statement from the Executive Yuan, as of 2022, LTC 2.0 has grown the number of service locations from 700 to 11,000; raised provider salaries; and boosted the coverage rate from 20% to 70% (Executive Yuan, 2022). Taiwan’s investment in LTC 2.0 has dramatically amplified government spending on long-term care services since 2017; as of 2022, the budget went from NT$5 billion (US$167 million) to over NT$60 billion (US$2 billion) (Executive Yuan, 2022). The spending has led to concern over the ability of the government to sustain the current financial model without going into a deficit, especially in the context of changing population age demographics. Since the LTC 2.0 was designed to be implemented for 10 years, until 2027, the government must evaluate how the funding of the LTC plan can accommodate the long-term care necessities of the rapidly aging population. Current health policy In 2024, the new Taiwanese administration introduced policies focused on preventative care to combat the effects of population aging. One prominent program is the Healthy Taiwan initiative, introduced in June 2024 by then president-elect and former physician Lai Ching-te. The program aims to raise life expectancy as well as reduce the time individuals spend with disabilities and chronic conditions (Office of the President, 2024). It integrates improved medical treatment, preventative care, and health promotion to reduce chronic disease rates through lifestyle changes. Key components are advanced preventive medical screenings at age 30, reducing cancer deaths by one-third by 2030 through early screening and treatment research, and the 888 Plan, which aims for an 80% control rate over hypertension, high blood pressure, and high cholesterol within eight years (Oung-On, 2024). While promising, Healthy Taiwan will require funding sources beyond the NHI’s current structure of low premium rates and expenditure caps (OungOn, 2024). Raising premium rates is highly unpopular, and a large portion of the NHI budget already falls on workers and employers. As a result, funding for the initiative will not come directly from the NHI budget. The specific funding mechanisms for the program remain unclear, but it may seek a model similar to long-term care funding. The 2024 administration has also unveiled a comprehensive plan to handle the workforce deficit. In July 2024, the cabinet introduced a 12-point plan to improve working conditions and maximize the number of nurses (Yu-Jen & Yang, 2024). The plan has incentives to hospitals to meet specific nurseto-patient ratios and aims for an additional 42,000 practicing nurses by 2030. To combat high attrition, there will be efforts to improve the working environment for nurses by reducing burnout, fostering supportive workplaces, and introducing smart technology to ease workloads. Furthermore, President Lai announced the Cultivation Plan as part of Healthy Taiwan, which invests in medical institutions and attracting talent to the field (Office of the President, 2024). These initiatives collectively represent Taiwan’s effort to strengthen the health-care workforce to meet the demands of an aging population. The shortage of working-age citizens has also reduced the number of funding contributors to the NHI, making it increasingly difficult to meet healthcare demands. In response, Taiwan amended the Labor Standards Act in July 2024 to allow employees to work beyond the mandatory retirement age of 65 (Kao, 2024). This amendment, along with added NHI funding through tax revenue, helps alleviate workforce supply. Continued workforce participation might also contribute to better health outcomes by promoting physical and mental activity, which would reduce strain on the system. Recommendations To mitigate the negative effects of the aging population on Taiwan’s health-care system and outcomes, a multifaceted approach can build on existing platforms and introduce new strategies. The recent changes in administration and health policies present a unique opportunity to strengthen the health-care delivery and promote healthy aging. Progress has been made, but Taiwan still faces underfunding of the NHI, rising costs of long-term care, and a workforce shortage. Policy reforms can use international examples of sustainable health care as models. Taiwan can respond by increasing the NHI budget, exploring tiered health care, adding to the number of nurses, and prioritizing preventative care and precision medicine. Taiwan’s health-care system and NHI have demonstrated remarkable adaptability in implementing reforms along with maintaining equitable access to care. Second Generation NHI introduced supple-
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