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。

The world’s first integrated National Health Insurance (NHI) was born in Taiwan in 1995. By 2008, the National Pension Insurance was set in place for those with weak economic ability, yet its benefit is 40% lower than those who had begun at the same starting point under the Labor Insurance. In 2026, it is forecasted that the estimated pension reserve of the Labor Insurance will run down to zero, pushing the system into bankruptcy. In 2017, the unhealthy life expectancy was 8.3 years for males and 9.8 years for females and is still rising. A few questions arise: Which long-term care (LTC) system is better for Taiwan, tax-financed or insurance? Rapid aging, fewer children, and slower economic growth have resulted in Taiwan’s social transformation, and thus how do these changes affect its social welfare systems and how should the systems be reformed? Over the past 30 years, Professor Lo has helped to establish the NHI financing system, evaluated the public pension systems, and participated in the design of the LTC insurance. She will explain in greater detail from the standpoint of an economist on why Taiwan is encountering such problems and where we should be going by rendering reform proposals for the welfare systems.

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