就如同其他工業化國家一樣，加拿大與台灣都面臨經濟成長的挑戰及其對人口老化所導致的社會福利制度的威脅。由於人類壽命延長，且家庭成員越來越少，世代傳承對較年輕的勞動力而言負擔日益沈重，社會保險制度也越來越難維持。慢性疾病的治療與長期照顧的成本增加使得健保制度壓力有增無減。爲解決這些問題，多項政策選擇常在各國政府政策辯論中出現，如延後退休的年齡、減少權利(entitlements)、健保改革與控制成本、開放勞工市場讓有限的外來移民來彌補社會勞力的不足。本文主旨比較加拿大與台海兩岸都面臨的社會人口老化問題。但是由於文化不同與各國經濟發展的階段不同以及社會制度不同，三國所處的困境迥異。首先，第一個主要差異是西方國家常依靠外來移民來防止人口老化問題，但是東亞國家卻很少有此作法。其二，由於加拿大已有相當完善的醫療健保制度，且採用引進外來移民，所以人口老化的負面衝擊比較和緩。台灣已有全民健保，雖可抒解一些人口老化的壓力，但是社會的變遷導致越來越多的老人得不到家庭的照顧，需倚賴社會服務，是社會的潛在危機。勞力不足與年輕人負擔加重則是另一項危機。而中國大陸的人口老化所導致的社會問題最嚴重，因爲目前醫療健保體系與制度迄未能因應此一問題，未來將可能會有嚴重危機。

Like all other societies in the industrialized world, both Canada and Taiwan are facing challenges to economic growth which threatens the resilience of their social welfare systems because of their aging populations. As people live longer and as they have smaller families, intergenerational transfers are becoming more onerous for the younger members of the workforce. Social insurance programs are becoming more difficult to sustain, and the rising costs of chronic disease treatment and long term care are putting strains on health care programs. Many policies are debated in the public sphere to address these problems: increasing the age of retirement, reducing entitlements, reforming and controlling costs of health care, and opening the labor market to a controlled immigration to offset the effects of society’s aging. In Western societies, all these policies are generating fierce resistances and their implementation is marred by disagreements over the role of the state and issues of national identities, although more liberal immigration policies represent less of an issue in a country like Canada, the United States, or Australia than in East Asia and Western Europe. In East Asia, these policies were never considered part of the policy mix because welfare regimes have been developed more recently. In Taiwan, the uncertainty about its future in relation to China and the exceptional nature of the latter’s welfare regime are presenting especially complex challenges. This article will focus on the specific challenges faced by the Republic of China (ROC, hereafter Taiwan), in relation to the unique situation of its giant neighbor, the People’s Republic of China (PRC, or in shorthand, China).