臺灣健保30週年：
創造全民均健，追求更健康臺灣
邱泰源部長
衛生福利部
中華民國（臺灣）
健康是基本人權，更是普世價值。提升健康不僅關乎增進人民福祉，更影響全球各國的生存與發展。第77屆世界衛生大會通過世界衛生組織(WHO) 2025-2028年第14個總體施政規劃」(GPW14)，其中包含「提升衛生服務覆蓋率和財務保護，促進全民均健」之策略目標，呼籲各國就相關議題採取行動。
臺灣早已於1995年開辦全民健康保險制度，藉由整合不同職業身份的保險體系，於今納保率超過99.9%，實踐全面健康覆蓋，30年來，提供臺灣人民公平、可近性高、且有效率的醫療保障，也是臺灣社會安定及民眾健康安全的重要支柱與保障，更成為全球健康照護的典範，已經連續7年獲得全球資料庫網站(Numbeo)全球健康照護指標(Health Care Index)排名第一。
臺灣健保的財務運作採隨收隨付、自給自足的模式，並透過保費改革及補充財源（如菸品健康福利捐），有效應對人口老化及醫療成本上升的財務挑戰，確保制度的穩定與永續。
為持續提升我國民健康，我國賴清德總統於2024年提出「健康臺灣」的施政願景，期盼讓人民健康，讓國家更強，也讓世界擁抱臺灣。秉持以人為本，家庭為核心，社區為基礎的理念，積極擴大健康促進與預防保健服務。透過「家醫計畫」與「全人全社區照護計畫」，提供慢性病患者全人全程的綜合照護；透過遠距醫療提高偏鄉地區服務可近性，也透過推動長期照顧與安寧療護的一體化服務，落實在地安老，確保全方位全人全齡有尊嚴的健康照護，實現健康平等的真諦。
此外，WHO於2021年發布2020-2025年全球數位健康策略文件，提出加速發展及運用以人為本(Person-centric)之數位健康方案，以預防、偵測與應對傳染性疾病，建立相關基礎設施和應用健康數據以促進健康與福祉。臺灣持續運用其資通訊優勢建構高成本效益及效率的衛生體系及服務，包括健保雲端系統提升病歷互通效率，並藉由快捷式健康照護可互通性資源(Fast Healthcare Interoperability Resources, FHIR)標準推動國際醫療資料的交換，透過AI輔助技術推動智慧醫療發展。虛擬健保卡與健康存摺APP實現了建立即時健康資訊管理，促進民眾作出有利健康的決定。
另自2008年起，我們引入醫療科技評估（HTA），以實證為基礎的政策決策促進新藥的快速納入健保，2023年首次納入基因及細胞治療藥品，開創精準醫療的先河，改善患者的治療選擇。我們也運用創新科技輔佐改善醫療環境，發展智慧醫療照護，提升整體醫療服務質量，提供民眾更好的照護品質。
臺灣雖面臨政治挑戰，卻始終積極參與全球衛生事務，並致力於支持全球衛生體系。在COVID-19期間，臺灣在防疫物資、技術和經驗分享中發揮關鍵作用，成為世界各國可靠的合作夥伴。此外，臺灣健保的經驗可為全球提供寶貴的借鑑，我們將繼續與各國分享全民健康保險、財務管理與數位健康等領域的成功實踐，助力更多國家實現WHO揭櫫的全球健康覆蓋目標。
在這個瞬息萬變的時代，健康挑戰跨越國界，全球合作已成為應對各種健康危機的關鍵。然而因中國不斷扭曲聯大第2758號及世界衛生大會第WHA25.1號兩決議，使得台灣無法參與WHO-全球最重要的健康合作體系。殊值得注意的是，該兩項決議並未提及台灣或台灣為中國的一 部分，亦未賦予中華人民共和國在WHO代表台灣的權利。
基此，為實踐聯合國包容及普遍性的核心價值，我們籲請WHO及相關各方正視臺灣長期以來對全球衛生體系的貢獻，敦促WHO應採取更開放的態度和彈性，秉持專業及包容的原則，主動並務實地邀請臺灣參加WHA及參與WHO主辦的會議、活動和機制，包括刻協商中的WHO大流行病協定。臺灣殷切期盼著能持續與國際社會攜手，共創無國界的健康未來，共同落實WHO憲章「健康是基本人權」及聯合國永續發展目標「不遺漏任何人」的願景。
Advancing health equity and promoting a healthier Taiwan on the 30th anniversary of Taiwan’s National Health Insurance system
Dr. Chiu Tai-yuan
Minister of Health and Welfare
ROC (Taiwan)
Health is a fundamental human right and a universal value. Improved health results in greater well-being for the people and has ramifications for the survival and development of a country and even the world. At the 77th World Health Assembly, members adopted the World Health Organization (WHO) Fourteenth General Programme of Work for 2025-2028. The program includes such strategic objectives as improving health service coverage and bolstering financial protections to ensure universal health coverage. WHO has called on all countries to take action on these issues.
As concerns universal health coverage, Taiwan launched the National Health Insurance (NHI) system in 1995. The scheme, which brought together already existing occupational insurance schemes, has reached its 30th year and now covers 99.9 percent of the population. The NHI system provides equitable, accessible, and efficient healthcare to all people in Taiwan. It is also an important pillar and guarantor of Taiwan’s social stability as well as people’s health and safety. It has, moreover, become a global benchmark for achieving universal health coverage. In an annual survey carried out by Numbeo, Taiwan has been ranked first in the Health Care Index category for seven consecutive years.
The NHI operates on a pay-as-you-go, self-sustaining model capable of addressing the financial challenges posed by an aging population and rising healthcare costs. By reforming premium rates and adding additional funding sources, such as the tobacco health and welfare surcharge, the system is on a sound, sustainable footing.
To promote the health of our people, President Lai Ching-te articulated a vision of a healthy Taiwan in 2024. This aims to ensure that people are healthy, the nation is strong, and the world is more ready to embrace Taiwan. Remaining focused on people, families, and communities, we are expanding health promotion operations and preventive healthcare. Moreover, we are implementing a family physician plan, offering comprehensive care to patients with chronic diseases, and utilizing telemedicine to improve healthcare accessibility in rural areas. By promoting integrated long-term care, palliative care, and aging in place, we ensure holistic, lifelong, and dignified care for all people, realizing health equity.
In 2021, WHO released the Global Strategy on Digital Health for 2020-2025. Under this plan, the global health body is seeking the development and adoption of person-centric digital health solutions to prevent, detect, and respond to infectious diseases. It is also overseeing development of infrastructure and applications to use health data to promote health and well-being. Taiwan continues to utilize its prowess in information and communications technology to build effective, high-ROI health systems and services. The NHI cloud facilitates the more efficient exchange of medical records, while the adoption of international standards such as Fast Healthcare Interoperability Resources enhances international medical data sharing. Additionally, the incorporation of AI-assisted technologies is advancing the development of smart healthcare. And the introduction of a virtual health insurance card and the My Health Bank app, which enables real-time management of personal health data, empowers people to make health-enabling choices.
In 2008, Taiwan introduced the Health Technology Assessment to facilitate evidence-based policymaking. It also accelerated the inclusion of new treatments under the NHI system. For example, in 2023, gene and cell therapies were covered for the first time, marking a new era for precision medicine and offering patients enhanced treatment options. Taiwan also continues to leverage innovative technologies to improve the working environment for the medical workforce and to bolster the overall quality of medical service.
What’s more, despite facing political challenges, Taiwan has continuously participated in international health affairs and has been dedicated to supporting the global health system. During the COVID-19 pandemic, Taiwan played a crucial role in sharing supplies, strategies, and experiences, and proved to be a reliable partner of countries worldwide. Separately, Taiwan’s success story in implementing universal health coverage offers valuable lessons for countries worldwide. As we continue to share our experiences in universal coverage, financial management, and digital health, we hope to facilitate other nations in reaching WHO’s goal of universal health coverage.
In this rapidly changing era, health challenges transcend borders, and global cooperation has become essential to addressing various health crises. However, Taiwan has been prevented from participating in WHO—the foremost global health cooperation body—due to China’s continued distortion of United Nations General Assembly Resolution 2758 and World Health Assembly Resolution 25.1. Neither of these resolutions mentions Taiwan or declares that Taiwan is part of the People’s Republic of China. Therefore, these resolutions have no power to confer upon the PRC any right to represent Taiwan in WHO.
In light of this, and to uphold the core UN values of inclusiveness and universality, we urge WHO and all relevant parties to recognize Taiwan’s considerable contributions to global public health and the human right to health. It is imperative that WHO adopt a more open-minded approach and demonstrate flexibility, adhering to the principles of professionalism and inclusivity. Taiwan should be included, as a matter of pragmatism, in the World Health Assembly and all WHO meetings, activities, and mechanisms, particularly those concerned with the WHO pandemic agreement. Taiwan earnestly hopes to work with the international community to create a future of borderless healthcare that realizes the fundamental human right to health stipulated in the WHO Constitution and the vision of leaving no one behind espoused in the United Nations Sustainable Development Goals.