National Health Insurance and Life Satisfaction in Late Life: Longitudinal Findings from a Natural Experiment in Taiwan

Using data from the Taiwan Longitudinal Study on Aging, this study sought to evaluate whether National Health Insurance (NHI) produces a longitudinal beneficial effect on life satisfaction of older Taiwanese adults. Results from growth curve models indicated a significant decline in life satisfaction after the 1999 Chi-Chi earthquake and no significant increase after 2003 SARAS; however, a significant increase in this after 12-year NHI establishment. In addition, the pre-NHI uninsured had a significantly lower level of life satisfaction before NHI establishment in comparison to the pre-NHI insured through Government Employee insurance (β=-1.38, p<0.05), even controlling for concurrent medical care utilization and health status. And, NHI significantly reduced gaps in life satisfaction between the pre-NHI uninsured and the pre-NHI insured over time. These findings suggest a long-term effect of the NHI policy on life satisfaction among older adults. The NHI efforts to promote life satisfaction among older adults should be recognized.