Is Taiwan's National Health Insurance a perfect system? Problems related to health care utilization of the aboriginal population in rural townships

National Health Insurance (NHI) was implemented in Taiwan in 1995, and has significantly increased coverage to 99% of the population. The implementation of NHI has had large impacts on health disparities. Despite that, the NHI faces multiple challenges, including the condition of "coverage without access" among the Taiwanese aboriginal population, mostly residing in mountainous townships and experiencing lower socioeconomic status, decreased health outcomes, and limited access to adequate high-quality health care services. This paper summarizes the persistent health gap and the differences in health care utilization and health outcomes between the aboriginal population in rural townships and urban populations in Taiwan. Mountainous townships face challenges including lack of access to high-quality health care services and limited medical resources. Further policy recommendations and current progress are highlighted and discussed.