Two essays on Taiwan's health care reform in the 1990s

This dissertation consists of two essays examining major health care reforms in Taiwan in the 1990s and their effects on the elderly. Both reforms are analyzed as natural experiments, comparing the experience of an affected group with a control group that was not affected.;The first essay investigates the National Health Insurance (NHI) program that provided universal coverage to Taiwan's 21 million citizens, including 8 million previously uninsured. The essay finds that NHI largely increased utilization for the previously uninsured elderly relative to their continuously insured counterparts. Corresponding to the increase in utilization, the mortality hazard ratio of the previously uninsured to the continuously insured elderly significantly dropped from 1.3 in the pre-NHI period to close to 1 in the post-NHI period, suggesting that NHI improved the health of the previously uninsured elderly through medical care.;The second essay inspects a special medicine culture in Taiwan---both physicians and pharmacists prescribed and dispensed drugs---which was profoundly changed in the 1990s by NHI and a separation policy (SP) that forbade physicians from dispensing and pharmacists from prescribing. The essay finds that NHI made the previously uninsured elderly more likely to visit physicians, including some who previously only visited pharmacists. Following this, the SP made all elderly patients more likely to only visit physicians and buy drugs from on-site pharmacists who were hired by physicians.