Taiwan

Aging arrived in Taiwan faster than almost anywhere on earth. At the end of 2025 it became a "super-aged" society, with about one in five people 65 or older, having made the jump from "aged" to "super-aged" in roughly seven years — against Japan's eleven and Germany's thirty-six — while births fell for a tenth straight year (Focus Taiwan). The whole system is operating under a time pressure most countries never faced.

The public answer is community-based, not institutional. Long-Term Care 2.0, launched in 2017, organizes services into a tiered "ABC" network — Tier A centers that build the care plan, Tier B institutions delivering home and day care, and Tier C neighborhood stations offering prevention, meals, and respite (Executive Yuan). The front door is a single free phone number, 1966, and that is the part worth borrowing: one call is meant to connect a family to coordinated, subsidised care, with reporting citing roughly 80% coverage. Few wealthy countries — the US among them — give families one number to call.

Most of the hands-on care, though, still comes from two places: family, and migrant workers. Confucian filial piety frames care as an adult child's moral duty, a source of devotion but also of guilt and depression as families shrink and adult children move away for work. To fill the gap, Taiwan relies on a large migrant care workforce — over 230,000 social-welfare workers as of October 2023, predominantly Indonesian women (Wikipedia).

That dependence has a hard edge. Migrant domestic caregivers are excluded from Taiwan's Labor Standards Act, so they have no minimum-wage floor, limited rest protections, and tight restrictions on changing employers; surveys cite high rates of no weekly day off. The affordability of the system rests, in part, on people with few rights — a caution for anyone tempted to call it a clean success.

Technology is advancing fastest in hospitals, not living rooms. The "Healthy Taiwan" initiative commits roughly US$1.5 billion to a sovereign AI-healthcare ecosystem, with hundreds of hospitals on interoperable records and an NVIDIA–Foxconn agentic-AI rollout across major medical centers (NVIDIA). At home the picture is earlier: IoT fall-detection wearables and smart-care villages are real and growing, while care robots like ASUS's Zenbo remain small pilots.

The financing question is the one to watch. Taiwan chose, in 2016, to keep long-term care tax-funded rather than adopt a Germany- or Japan-style insurance scheme (ScienceDirect). Total spending sits near 0.26% of GDP, and reporting now warns the fund may last only about five more years — putting the long-debated insurance model back on the table (Taiwan News). The honest reading: Taiwan built the navigable front door the US lacks, and is now living the question of how to pay for what walks through it.