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This paper estimates the price elasticity of healthcare utilization in early childhood. We employ a regression discontinuity design by exploiting a subsidy that reduces patient cost-sharing for children under age 3 in Taiwan. Using longitudinal medical claims of over 410,000 children, we find a modest price elasticity of outpatient expenditure (e.g., −0.10 for regular outpatient care). Furthermore, increased cost-sharing at age 3 largely decreases the chance of visiting high-intensity healthcare providers (e.g., teaching hospitals) for minor illnesses. In contrast, children’s utilization of inpatient care is price insensitive, providing a rationale for full inpatient care coverage to children.

This paper examines the causal effect of corporate tax audits on firms' behaviors using a unique corporate tax audit policy in Taiwan, which involves lower audit effort for firms with reported revenues just below 30 million NTD. The study focuses on how firms \"control\" the cost and expense to minimize their tax burden. To simplify the analysis, we investigate whether there is a significant difference in salary expenditure between the firms which file their tax returns under a unique corporate tax audit policy and those do not. We use the corporate tax return data and income registry data from the Fiscal Information Agency between 2004 and 2014. To reduce the selection bias, the \"propensity score matching\" method is adopted. We find this policy significantly decreases reported salary expenditure, and leads to annual tax losses of about 2 billion to 3 billion.

In 2011, an Amendment to the \"National Health Insurance Act\" added a new supplementary premium by expanding the calculation base for employees. This is to be implemented on January 1, 2013. This approach will also reinforce the ability-to-pay principle and enlarge the premium base. An insured person will have to pay 2 percent of extra income, including that from interest, professional practice income, rent, stock dividends and bonuses exceeding the equivalent of four months' wages, as their supplementary premium for NHI. This study investigated the problems associated with this supplementary premium based on considerations of equity, neutrality, adequacy, stability, compliance and the administrative aspects, and provides suggestions for improvement. [PUBLICATION ABSTRACT]

The Ministry of Health and Welfare in Taiwan has indicated that a new financing mechanism broadening the premium base from the payroll tax to family income will be proposed under third-generation National Health Insurance. This study compared the existing system with the new financing mechanism, analyzed the advantages and shortcomings based on considerations of equity, neutrality and administration, and reviewed the related controversies caused by enlarging the premium base. We also provide suggestions for the government in formulating third-generation National Health Insurance in the future. [PUBLICATION ABSTRACT]

Objectives: The aim of this study was to evaluate the impact of the increase in NHI copayments in 2005 on the choice and use of health care. Methods: We analyzed the outpatient utilization of one million NHI enrollees between 2004 and 2006. Because the policy increased only the copayment for hospital visits, it was plausible to expect that the effect would be smaller for individuals residing or working in towns with a lower propensity for visiting hospitals. Therefore, based on the average percentage of clinical care in the town of residence, the sample was separated into three groups: less than 65% (group I), between 65 and 75% (group II), and more than 75% (group III). We then used the Hurdle regression model to examine the effect of the new policy on the probability of health care utilization, and the number of outpatient visits for each group. Results: Our results showed that the increase in copayment significantly reduced the probability and the number of outpatient visits. We estimated that outpatient u

This paper utilizes wealth shocks from winning lottery prizes to examine the causal effect of financial resources on fertility. We employ extensive panels of administrative data encompassing over 0.4 million lottery winners in Taiwan and implement a triple-differences design. Our analyses reveal that a substantial lottery win can significantly increase fertility, the implied wealth elasticity of which is around 0.06. Moreover, the primary channel through which fertility increases is by prompting first births among previously childless individuals. Finally, our analysis reveals that approximately 25% of the total fertility effect stems from increased marriage rates following a lottery win.

Rapid population aging and wage stagnation among young people have negatively affected the finances of the National Health Insurance (NHI) program as well as exacerbated intergenerational inequality in Taiwan. In this study, population aging and wage stagnation were included in the model to estimate premium bases and benefit payments, which were then used to calculate the balance of payment rates and intergenerational premium burdens of NHI. Given the general premium rate without the rate ceiling of 6% and an estimated scenario with moderate population projection and moderate negotiated budget growth, the current 4.69% premium rate of the NHI would rise to 12.28% in 2041, and the rate would be higher for people born in later years. To mitigate the negative effects of population aging and wage stagnation that disproportionately impose the financial burden of paying NHI premiums on younger generations and eliminate the intergenerational inequality in NHI, reforms are necessary that implement a revenue-payment-l

Using administrative data on Taiwanese lottery winners, this paper examines the effects of cash windfalls on entrepreneurship. We compare the start-up decisions of households winning more than 1.5 million NTD (50,000 USD) in the lottery in a particular year with those of households winning less than 15,000 NTD (500 USD). Our results suggest that a substantial windfall increases the likelihood of starting a business by 1.5 percentage points (125% from the baseline mean). Startup wealth elasticity is 0.25 to 0.36. Moreover, households who tend to be liquidity-constrained drive the windfall-induced entrepreneurial response. Finally, we examine how households with a business react to a cash windfall and find that serial entrepreneurs are more likely to start a new business but do not change their decision to continue the current business.

In May 2005, Bureau of National Health Insurance doubled the reimbursement for vaginal delivery to the same rate as paid for cesarean section (c-section) in order to reduce the c-section rate and improve the quality of care. This reimbursement adjustment provides an excellent opportunity to examine whether such a payment increase can improve healthcare quality. Using obstetric cases of firstborns in 2004 and 2006 from National Health Insurance Data, this study examines if there was a negative relation between quality indicators (e.g. c-section, re-admission, and length of stay) and doctor's income, measured in terms of payments paid by NHI for baby delivery. To control for the endogenous bias, the study employs \"first-difference\" methods to attenuate the bias arising from unobserved factors, and restricts the sample to firstborn babies. Our results indicate that the doctor's income and c-section rate is statistically uncorrelated on the whole, but negatively related for doctors who previously had a lower perc

This paper estimates individual wealth distribution including houses, land, stocks, deposits, bonds, short-term transaction instruments, and mortgage by using the individual wealth register data of the Ministry of Finance from 2004 to 2014 and combining their with the method of capitalization. To ensure that the results are close to reality, we use the price data in the Actual Transaction Price of Real Estate to evaluate the values of houses and land. We also consider both direct and indirect holdings of stocks when we measure wealth. According to our calculation, the Gini coefficient of wealth in Taiwan is about 0.79, and the top 10% and top 1% wealth shares are 62% and 23% respectively. The wealth inequality in Taiwan is lower than in the U.S., approximating the results in Korea and Sweden. Moreover, the wealth in Taiwan between 2004 and 2014 showed a trend of concentration towards the elderly population over 50 years old.