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The ordinary virtue of health systems is to secure some form of equitable access to health services for all in pursuit of the ideal of universal health coverage, which would sometimes be considered an integral part of the overall institutional arrangements protecting the human right to health. The history of human-established health systems has come close to an end. In this article, I use the Taiwanese health system as an illustrative case to demonstrate how the roles of a health system vary in different periods across multiple colonial histories. It was not until the 1990s, after Taiwan went through democratisation, that the health system began to display ordinary virtue. I further argue that, beyond the ordinary virtue, the Taiwanese health system has moral significance in (1) integrating divided and conflicting identities and forging a new, forward-looking one; and (2) representing Taiwanese people’s declaration against exclusionary global politics by devoting themselves to a space that protects the right to health and a way of life that cherishes the value of equitable access to health services for all. [ABSTRACT FROM AUTHOR]

This article aims to untangle the puzzle of why the childcare sector often allocates the least of responsibility for care to the state in societies with Confucian social ethos compared with the healthcare and long‐term care sector. Using Taiwan as an illustrative case, the article offers an overview of the three care sectors and an in‐depth analysis of the development of the childcare sector. We argue that due to the diminished bureaucratic authority after the democratization process and the application of elder culture, the childcare sector is much less well‐developed than the other two sectors in Taiwan. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments' early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events. [ABSTRACT FROM AUTHOR]

Throughout the world, national policymakers are being pushed, by ageing populations, low fertility rates and changing cultural values, to find innovative and sustainable policy solutions to meet the needs of [...]

Singapore's health system generates similar levels of health outcomes as does Sweden's but for only 4.4% rather than 11.0% of gross domestic product, with Singapore's resulting health sector savings being re-directed to help fund both long-term care and retirement pensions for its elderly citizens. This paper contrasts the framework of financial risk-sharing and the configuration and management of health service providers in these two high-income, small-population countries. Two main institutional distinctions emerge from this country case comparison: (1) Key differences exist in the practical configuration of solidarity for payment of health care services, reflecting differing cultural roots and social expectations, which in turn carry substantial implications for financing long-term care and pensions. (2) Differing arrangements exist in the organization of health service institutions, in particular balancing public as against private sector responsibilities for owning, operating and managing these two countries' respective hospitals. These different structural characteristics generate fundamental differences in health sector financial and delivery outcomes in one developed country in Far East Asia as compared with a well-respected tax-funded health system in Western Europe. In the post-COVID era, as Western European policymakers find themselves forced to adjust their publicly funded health systems to (further) reductions in economic growth rates and overall tax receipts, and as the cost of the information revolution continues to rise while efforts to fund better coordinated social and home care services for growing numbers of chronically ill elderly remain inadequate, this two-country case comparison highlights a series of health system design questions that could potentially provide alternative health sector financing and service delivery strategies. [ABSTRACT FROM AUTHOR]

Compared with data that is initially collected for research purposes, the mandatory authorization of a government database for secondary use deserves greater scrutiny because it consists of information that is collected initially for administrative purposes. Using the case of Taiwan's National Health Insurance (NHI) Database as an example, this paper analyzes the ethical issues that emerge when the research participants are "participated" in studies without their consent, according to the current policy. The proponents of secondary use for research purposes maintain that the authorized use of the NHI Database is necessary for public interests, while the opponents argue that the potential lack of democratic accountability and the infringement on people's rights to privacy and information autonomy is unwarranted. Drawing on the solidarity-based approach, this paper proposes a temporal solution as a possible reform direction for better ethical justification of the secondary use of the NHI Database. [ABSTRACT FROM AUTHOR]

This paper reviews the past development of the publicly funded long-term care (LTC) system and aims to advance further discussion of LTC in Taiwan. The Ten-year Long-Term Care Plan 2.0 introduced in 2017 calls for a major reform of a publicly funded LTC system in Taiwan. The reform expands on the previous universal tax-based LTC system, allowing for more comprehensive and accessible subsidies on LTC services. This paper provides a brief overview of the political context of the reform and an introduction to the legal basis, financing and delivery mechanisms of the reform plan. To this end, as a preliminary evaluation, this paper identifies major institutional and socio-cultural tensions that could challenge the implementation of the plan. Institutional tensions include the dominant foreign worker caring model, which relies on approximately 220,000 foreign workers to provide LTC services, and the discontinuity between health and social care governance, which leads to a discontinuity between curative and LTC care. Socio-cultural tensions focus on conflicting values in the allocation of responsibility of care and in the understanding of disability between universal social citizenship in the modern state and traditional Confucian ethics. Policy implications of these tensions for the LTC system are then discussed. [ABSTRACT FROM AUTHOR]

Context: Conventional wisdom suggests that people with a collectivist tradition tend to comply more with the government's regulatory and even coercive disease-prevention policies. Besides this socio-cultural element, political partisanship is also an important aspect relating to people's willingness to cooperate with the government. This study aims to examine the relationships between these two factors and three dimensions of vaccination policy attitudes: common responsibility to take the vaccine, the government's vaccine mandate, and indignation over anti-vaxxers., Methods: Using the data from a nationally representative cross-sectional survey conducted in 2022 in Taiwan, this study applies multiple linear OLS regression to examine the relationships between vaccination policy attitudes and Confucian collectivism and political partisanship., Findings: Confucian collectivism and political partisanship aligning with the ruling party are associated with supportive vaccination policy attitudes. For those who do not align with the ruling party, the negative attitudes toward the vaccination policy appear in different dimensions according to the party they lean to., Conclusions: Confucian collectivism is prevalent in Taiwan and is related to public attitudes toward vaccination policy. This association is independent of political partisanship. Public health authorities should consider the socio-cultural context and political atmosphere for the effectiveness of disease-prevention measures., (Copyright © 2024 by Duke University Press.)

This paper comments on Naoki Ikegami's editorial entitled "Financing long-term care: lessons from Japan." Adding to the editorial, this paper focuses on analyzing the political and cultural foundations of long-term care (LTC) reform. Intergenerational solidarity and inclusive, prudential public deliberation are needed for the establishment or reform of LTC systems. Among various lines of ethical reasoning related to LTC, Confucian ethics and other familist ethics are specifically important in the societies that share these values. The core issue in the debates around LTC reform is how to (re-)define the scope of social entitlements and accordingly to allocate the responsibility for care between states and families, between social groups, and between generations with limited resources., (© 2020 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)