Chuan-Feng Wu


Since a great paradox lies beneath the universal health insurance mandate debate in both Taiwan and the U.S., Taiwan’s experience clarifying the constitutionality of its compulsory universal health insurance program might provide valuable lessons to the U.S. The goal of this Article is to provide a theoretical basis, based upon the human rights impact assessment in public health policies and a Rawlsian theory of justice, to decide whether the restriction on individual liberty imposed by Taiwan’s compulsory NHI is constitutionally justified. An analytic four-step assessment is established to evaluate the NHI’s burden on individual liberties: (1) examine the importance, legitimacy, and contents of the freedom to purchase or decline health insurance in social health programs, (2) clarify the NHI’s proposed policy purposes, (3) evaluate likely policy effectiveness, and (4) apply the “importance test,” based upon Rawls’ liberty and priority principles, to assess the trade-offs between the restricted liberty and the pursued social benefits in the case of NHI.