If I may add, Bill:

I haven't paid taxes since I became a citizen (1994)as local teachers and the military are tax-exempt. There's been talk that this will come to an end (this year?) but, even then, the tax rate is 6%.

Expat teachers are taxed 20% for the first six months and then pay 6%. Upon leaving the country they'll get a tax return.

The monthly premium is $20 and then there's a tobacco tax surcharge that goes to the NHI, and contributions from the national lottery. Families pay a lower rate.

As for elder care, it's tradition that family members take care of their parents so having three generations under one roof is very common. Nursing homes aren't very popular and filial piety is still mainstream. Parents that live with their children or on their own are paid monthly allowances by their children. Even working parents with married children receive such allowances.

And then there's the Smart Card:

The new healthcare cards completely replaced the old paper cards. The new smart cards consolidate functions of four different vouchers, including the regular paper card, the Children's Health Handbook, the Prenatal Exam Handbook and the Catastrophic Illness Certificate. To the card holder, it is two cards and two handbooks all-in-one, and also a great convenience: not having to renew the card every six visits. To the healthcare providers (medical institutions), proof of identification is faster and accurate and transactions are more efficient, allowing them to focus on their core services instead of administrative work. To the Bureau of National Health Insurance, information became highly manageable and timely, and fraud is drastically reduced.

Taike