Taiwan established universal national health insurance in 1995, bringing overnight the then 41 percent uninsured under the umbrella of national health insurance (NHI). Financial worry due to illnesses is a thing of the past in Taiwan. As a result of successful cost containment, national health spending grew from the pre-NHI three-year average of 4.79 percent of gross domestic product (GDP) to only 6.1 percent today. Tsung-Mei Cheng explores with Taiwan's health minister Ching-Chuan Yeh, M. D., the ethical principles that underlie the NHI and how the NHI operates: financing, risk pooling, cost containment, provider payment, and the delivery system. Challenges for the future are discussed. [Health Affairs 28, no. 4 (2009): 1035-1044; 10.1377/hlthaff.28.4.1035]