Taiwan has now become what is known as a super-aged society, in which more than 20% of the population is aged 65 or above, increasing pressure on the healthcare system from chronic diseases, age-related disability, infectious threats, and cancer.

While Taiwan has made significant progress in expanding healthcare access and treatment capacity, current policy frameworks remain weighted toward downstream care, limiting the system’s ability to intervene early, manage risk proactively, and contain long-term costs.

To realize the Lai Ching-te administration’s Healthy Taiwan vision and strengthen healthcare system resilience, the Committee recommends that public health policy be formulated with greater emphasis on prevention, early intervention, precision care, and digital innovation. In particular, more effective alignment is needed across existing programs to address fragmentation in chronic disease management, gaps in early-stage intervention for aging-related conditions, and underutilization of data-driven tools in care delivery.

The Committee therefore recommends a more integrated and outcome-oriented approach that connects chronic disease governance, healthy aging, immunization, smart healthcare, and cancer control through cross-sector coordination and public-private collaboration. Strengthening these linkages will be essential to improving population health, reducing avoidable disease burden, and sustaining Taiwan’s healthcare system in the face of demographic change.

Suggestion 1: Strengthen chronic disease governance and healthcare system resilience through precision care.

As Taiwan’s population ages, chronic diseases such as diabetes and chronic kidney disease continue to drive a growing share of healthcare utilization and National Health Insurance (NHI) expenditure. Those two diseases alone account for over NT$100 billion a year in costs, according to National Health Insurance Administration (NHIA) data. Taiwan’s chronic disease policies have established an important foundation for prevention and risk stratification.

To better support the goals of the 888 Plan, the Committee recommends advancing toward a more precision care–oriented model that embeds risk stratification, strengthening early intervention for high-risk populations for more personalized treatment approaches aligns incentives with prevention outcomes, and coordinates multidisciplinary management These measures will support the Healthy Taiwan objective of reducing chronic disease mortality and shorten the number of unhealthy years from the current average of eight.

1.1   Strengthen precision care for diabetes and chronic kidney disease. Diabetes and chronic kidney disease are among the leading contributors to NHI expenditure, with demand expected to rise further as the population ages. Despite the prevalence of these conditions, current management approaches do not consistently differentiate patients based on risk level, leading to delayed intervention among high-risk populations.

The Committee recommends strengthening risk stratification within existing care frameworks by prioritizing early identification and proactive management of high-risk patients, including those with poor glycemic control, high body mass index, multiple comorbidities, or early signs of renal impairment.

In addition, early referral and timely enrollment into specialized care networks should be expanded for immune-mediated and other complex kidney diseases to delay disease progression and reduce long-term costs. Meanwhile, given diabetes is a major driver of cardio-renal deterioration, strengthening cross-specialty co-management between endocrinology, nephrology, and primary care would further improve care continuity and outcomes.

1.2   Align incentives and governance through a cross-sector chronic disease management mechanism. Current chronic disease programs, including Pay-for-Performance models, have improved care quality but remain fragmented across providers and levels of care. Incentives are not consistently aligned with early intervention or long-term outcomes. For example, the reimbursement points for early-stage chronic kidney disease is much lower than for metabolic syndrome or diabetes, affecting the willingness of medical institutions to enroll patients.

The Committee recommends establishing a National Chronic Disease Cross-Sector Alliance to coordinate medical centers, regional hospitals, and primary care providers, while integrating government and academic stakeholders. This mechanism would support alignment of clinical protocols, data sharing, and workforce development.

At the same time, we recommend that risk stratification be embedded into program design and performance indicators. Measures should include incorporating early risk identification tools into routine care and linking reimbursement more closely to preventive outcomes, such as improved disease control and reduced complications.

Since Executive Yuan has recently announced Healthy Taiwan will prioritize obesity care and fatty liver care, we suggest that obesity management for adults, children, and adolescents should also be recognized as a critical upstream component of precision care and P4P strategies. Drawing on international practices such as Korea’s NHI, the Committee recommends integrating BMI into standardized monitoring under Taiwan’s 888 Program and prioritizing overweight and obese populations for comprehensive, longitudinal management, including lifestyle and pharmacological interventions where appropriate, in line with the government’s preventionfirst policy. Parallel efforts should strengthen childhood and adolescent obesity guidelines and advance familycentered interventions to enhance chronic disease governance and healthcare system resilience.​

Suggestion 2: Strengthen early intervention to prevent age-related disability and extend healthy life expectancy.

In response to the growing burden of age-related functional decline, early intervention is essential to slow deterioration, prevent frailty from progressing into disability, and maintain independent living among older adults. It also plays a critical role in reducing long-term caregiving burdens on families and society.

Data from the Health Promotion Administration show that approximately 30% of Taiwan’s population aged 65 and above is already at risk of disability or frailty, underscoring the urgency of intervention at the pre-disability stage. For a super-aged society, a policy approach focused primarily on expanding long-term care capacity will not be sufficient to address the projected increase in disability.

The Committee therefore recommends shifting policy priorities upstream toward early identification and intervention before the onset of disability. Such an approach would help delay functional decline and support the Healthy Taiwan objective of reducing unhealthy life expectancy from around 10% to 8%.

2.1   Advance early-stage dementia policies and brain health management. Dementia represents a growing challenge to both healthy aging and the sustainability of the long-term care system. Current policy frameworks remain largely focused on moderate to severe stages of disease, emphasizing downstream care services over early intervention.

With advances in early detection and the emergence of disease-modifying therapies for Alzheimer’s disease, there is a need to reposition policy toward earlier stages of cognitive decline. The Committee recommends shifting from a disability-focused model to a more comprehensive brain-health management approach, with particular emphasis on individuals with very mild or mild dementia.

The Committee recommends that this shift be supported by strengthened healthcare system readiness for early diagnosis and precision treatment. Priorities include expanding access to biomarker-based diagnostics, such as blood-based screening and positron emission tomography (PET) or cerebrospinal fluid testing, and facilitating the appropriate introduction of emerging therapies. Advancing these capabilities would enable earlier intervention, help slow disease progression, and reduce long-term care needs.

2.2   Strengthen integration of early disability intervention in stroke and neurodegenerative care. In alignment with the Long-Term Care 3.0 objective of preventing and delaying disability, the Committee recommends strengthening integration between post-acute care and long-term care systems, with particular focus on stroke and neurodegenerative diseases.

Improving continuity of care following acute events is critical to preserving functional independence, reducing the risk of recurrence, and maintaining quality of life. While recent policy efforts have sought to enhance the post-acute care window and improve transitions to long-term care by increasing referrals from major medical centers to community hospitals, further refinement is needed to ensure consistent and effective implementation.

We recommend introducing integrated care models supported by appropriate payment incentives to strengthen case management and care coordination. Drawing on established chronic disease management models, dedicated care managers working alongside physician-led teams could support risk-factor control, rehabilitation adherence, and long-term monitoring. Such an approach would improve outcomes, reduce avoidable disability, and enhance the overall effectiveness of early intervention policies.

Suggestion 3: Strengthen immunization and infection prevention to support Healthy Taiwan objectives.

Vaccination remains one of the most effective public health interventions for extending healthy life expectancy, reducing severe illness and mortality, and alleviating healthcare system burden. Multiple international studies have shown that greater vaccination coverage is associated with lower hospitalization rates and improved population health outcomes.

Despite these benefits, adult and elderly vaccination coverage in Taiwan remains relatively low. Influenza vaccination coverage among adults aged 65 and above is around 50%, while pneumococcal vaccination completion rates remain below 40%, with many older adults unvaccinated. In a super-aged society like Taiwan, strengthening immunization strategies will be essential to reducing preventable disease burden and supporting healthcare system resilience.

The Committee recommends strengthening immunization policy through improved system integration, public communication, sustainable financing, and regulatory efficiency.

3.1   Integrate vaccination into chronic disease management and care delivery systems. Vaccination should be embedded within existing healthcare delivery frameworks to improve uptake among high-risk populations. Publicly funded pneumococcal and Covid-19 vaccinations could be incorporated as tracking indicators under the Family Physician Program and related initiatives.

The Committee recommends strengthening cross-ministerial coordination to integrate vaccination into programs such as the 888 Chronic Disease Prevention Program, Long-Term Care 3.0, and the Cancer Care Quality Improvement Program. Embedding vaccination into routine care workflows, supported by digital reminder systems, would enable proactive identification and improve completion rates.

3.2   Strengthen public communication and public-private collaboration to improve vaccine uptake. The Committee urges the Taiwan Centers for Disease Control (CDC) to enhance communication through coordinated, multi-channel approaches that provide clear, evidence-based information across the life course. The CDC is encouraged to consolidate and regularly update vaccine-related information in accessible formats, while improving transparency in vaccination coverage data.

Digital tools, including the Health Coin initiative and My Health Bank application, can support reminders and incentives, particularly for older adults. In parallel, establishing regular dialogue and data-sharing mechanisms between government and industry would strengthen coordination and support vaccine uptake.

3.3   Ensure sustainable vaccine financing and clear pathways for new vaccine inclusion. The Committee recognizes the increased public budget contribution to the National Vaccine Fund, which this year has reached 76% (with the remainder from the tobacco surcharge). Maintaining stable funding levels and introducing gradual adjustments to reflect demographic changes will support long-term sustainability.

To build on this momentum, the Committee recommends establishing a transparent pathway for the evaluation and inclusion of new vaccines, with indicative timelines, would improve planning and facilitate timely access.

3.4   Enhance regulatory efficiency for vaccine lot release and testing. Taiwan’s batch-by-batch testing system has ensured strong vaccine quality. The Committee recommends assessing the adoption of a more risk-based, tiered testing approach, such as conducting full-panel testing for the first three batches of new vaccines, followed by simplified testing with a shorter timeline for subsequent batches.

Adoption of documentation-based review, recognition of testing and releasing from the EU or A10 countries, and the adoption of sampling-based testing approaches could improve overall efficiency while maintaining quality standards. At the same time, strengthening testing capacity will be essential to support these adjustments and ensure readiness.

Suggestion 4: Scale up the Health Coin ecosystem and advance contactless smart healthcare.

To support the Healthy Taiwan vision and strengthen healthcare system resilience, the Committee urges the government to further develop smart healthcare policies that shift care toward prevention, expand access, and improve system efficiency. While initiatives such as the Health Coin program and My Health Bank platform provide a strong foundation, current applications remain limited in scope and are not yet fully integrated into routine care or daily health management.

The Committee recommends expanding these initiatives into a more integrated digital health ecosystem that supports continuous care, incentivizes preventive behavior, and enables more efficient service delivery.

4.1   Scale up the Health Coin ecosystem by integrating preventive behaviors and home-based care. The current Health Coin framework, which includes government-issued digital incentives earned through preventive health activities and redeemable for health-related goods and services, focuses primarily on discrete clinical services such as screening and vaccination. Expanding the program to include high-frequency preventive behaviors would support more sustained health management.

The Committee recommends establishing standardized data authentication mechanisms through the My Health Bank platform to enable the integration of verified data from wearable devices and home-based monitoring tools, including physical activity and weight management indicators. Linking incentives to verified outcomes would strengthen participation while maintaining data reliability.

 In addition, patients receiving such home-based care as home dialysis should be incorporated into the Health Coin program. Aligning incentives with self-management would support the expansion of home-based care models and reduce pressure on healthcare facilities.

4.2   Bolster public-private collaboration through a data-enabled incentive framework. To expand participation while safeguarding personal data, the Committee recommends enabling the use of government-verified, de-identified health achievement signals, such as completion of screenings or wellness targets, which allow private-sector partners to offer complementary incentives without accessing individual health records. This approach would lower barriers for sectors such as fitness, wellness, and nutrition to contribute to national health objectives while maintaining robust data governance standards.

4.3   Advance contactless care through integration of telehealth and service delivery systems. In a super-aged society, digitally enabled care models are essential to maintaining accessibility and continuity of care. While telehealth services have expanded, integration across consultation, prescription, and delivery systems remains incomplete.

The Committee recommends strengthening the Family Physician Program by integrating teleconsultation, electronic prescriptions, digital payment, and pharmaceutical logistics into a more seamless care model, particularly in remote and underserved areas.

Over time, deeper integration with My Health Bank and the use of data-driven risk identification tools could support earlier intervention and more continuous care for all patients with chronic conditions.

Suggestion 5: Establish a comprehensive cancer control framework.

Cancer has remained the leading cause of death in Taiwan for more than four decades, with the mortality rate continuing to rise. As the population ages, achieving the government’s target of reducing cancer mortality by one-third will require a more integrated and outcome-oriented national strategy.

The Committee recommends strengthening cancer control through more effective screening, improved access to diagnosis and treatment, and sustainable financing mechanisms. Aligning these efforts with clear, internationally comparable performance indicators will be essential to improving early detection, treatment outcomes, and long-term survival.

5.1   Expand and target screening to improve early detection and prevention outcomes. The Committee welcomes the government’s increased investment in cancer screening, including the expansion of HPV testing, vaccination, and gastric cancer screening. However, screening participation remains uneven. Among the six existing programs, only cervical cancer screening has exceeded a 50% participation rate, while breast and colorectal cancer screening remain below 40%. A large proportion of the population has never been screened, contributing to late-stage diagnosis and poorer outcomes.

Certain cancers, including head and neck, ovarian, and prostate cancer, are frequently diagnosed at advanced stages, with prostate cancer mortality continuing to rise and a high proportion of cases detected at stage IV.

The Committee recommends increased screening coverage for the most prevalent cancers and adopting more targeted, risk-based screening strategies. Measures could include stratifying population groups according to risk and tailoring health literacy and engagement efforts accordingly, expanding public awareness and outreach, and combining digital reminder systems with non-digital approaches to improve participation. Addressing urban–rural disparities and expanding mobile health services will also be important to improving access.

5.2   Improve access to timely diagnosis and treatment through strengthened performance indicators. Improving survival outcomes will require more timely diagnosis and access to appropriate treatment. The Committee suggests further optimizing reimbursement for next-generation sequencing to align with international clinical guidelines and expand access to precision diagnostics across cancer types. Strengthening the linkage between diagnostics and treatment decisions will support more effective, guideline-concordant care.

At the same time, steps should be taken in the reimbursement processes for innovative therapies to reduce delays or access restrictions driven solely by budget controls.

To support accountability and policy effectiveness, the Committee urges the introduction of internationally comparable performance indicators, including time to treatment, treatment completion rates, and survival outcomes. Regular monitoring of these indicators would strengthen evaluation of progress toward reducing cancer mortality.

5.3 Strengthen sustainable financing through expansion and institutionalization of the Cancer Drugs Fund. The establishment of the Cancer Drugs Fund represents an important step in addressing unmet medical needs. However, its scale and long-term sustainability remain critical considerations.

The Committee recommends expanding the fund toward a NT$10 billion level and incorporating unmet medical needs as a key criterion in resource allocation, alongside disease burden. Securing stable and predictable funding sources, as well as establishing a clear legal framework, will be essential to ensuring long-term effectiveness.

As therapies supported under the fund are expected to transition into the NHI system, it will be important to align funding mechanisms in advance to ensure continuity of care. A predictable transition framework would help avoid treatment disruption and support stable integration into the broader reimbursement system.