An analysis of welfare and health policy changes on the health seeking behavior of Taiwanese immigrants residing in the United States

Abstract

Due to recent policy changes in the United States and Taiwan, Taiwanese immigrants residing in the United States now face a choice of continuing to receive health care in the United States or returning to Taiwan for treatment care. This study uses a mixed method approach including a quantitative survey with 583 respondents and a qualitative study comprised of 14 interviews conducted by this researcher to explore the association between recent welfare and health policy changes and the health seeking behaviors of Taiwanese immigrants residing in the United States. The survey findings show that 47.5% of the respondents stated that they were strongly considering returning to Taiwan for health care under the new Taiwanese national health insurance plan (2nd NHIA). Logistic regression methods were used to address the primary research question --"Why do legal Taiwanese immigrants residing in the United States strongly consider or reject returning to Taiwan for health care under the new legislation?" These findings indicate that there are statistically significant associations between a variety of factors and the Taiwanese immigrants' desire to return to Taiwan for health care under the new national health insurance plan (2nd NHIA). The variables positively associated with a desire to return to Taiwan for health care include the length of domicile and residence required to receive benefits, a nostalgic desire to return to Taiwan, the lower cost of health care in Taiwan, and if the respondents had come to the U.S. before 1996. The negatively associated variables include having a job in the U.S., having a desire to return to Taiwan to live after retirement, the language preference in communications with a doctor, and a preference about the best place to receive dental treatment. Age and self-reported health were mediating variables. The study reveals the dynamics behind the health care decision-making of Taiwanese immigrants and particularly their choice of whether to seek care in the United States or in Taiwan.