1995年，臺灣開辦了全世界第一個單一體制的全民健康保險；2008年開辦國民年金，以相同條件投保的人，國民年金的福利比勞保年金少40%；2026年之前，預計勞工保險基金累積餘額將用完，制度面臨破產；2017年臺灣不健康平均餘命，男、女性分別為8.3年、9.8年，且持續增加中；老人的長期照顧應採稅收制或保險制？人口老化、少子化、經濟成長減緩等因素促成社會轉型，對臺灣的社會福利制度有何影響？要如何因應調整？羅紀琼女士從制度經濟學的觀點，就親身參與規劃全民健康保險制度及相關社會福利政策三十年的經驗，說明這些問題形成的原因，並提出宏觀視野的改革方案。
Theworld’sfirstintegratedNationalHealthInsurance(NHI)wasborninTaiwanin1995.By2008,theNationalPensionInsurancewassetinplaceforthosewithweakeconomicability,yetitsbenefitis40%lowerthanthosewhohadbegunatthesamestartingpointundertheLaborInsurance.In2026,itisforecastedthattheestimatedpensionreserveoftheLaborInsurancewillrundowntozero,pushingthesystemintobankruptcy.In2017,theunhealthylifeexpectancywas8.3yearsformalesand9.8yearsforfemalesandisstillrising.Afewquestionsarise:Whichlong-termcare(LTC)systemisbetterforTaiwan,tax-financedorinsurance?Rapidaging,fewerchildren,andslowereconomicgrowthhaveresultedinTaiwan’ssocialtransformation,andthushowdothesechangesaffectitssocialwelfaresystemsandhowshouldthesystemsbereformed?Overthepast30years,ProfessorLohashelpedtoestablishtheNHIfinancingsystem,evaluatedthepublicpensionsystems,andparticipatedinthedesignoftheLTCinsurance.ShewillexplainingreaterdetailfromthestandpointofaneconomistonwhyTaiwanisencounteringsuchproblemsandwhereweshouldbegoingbyrenderingreformproposalsforthewelfaresystems.
