On Tuesday, the Chinese Nationalist Party (KMT) will use its legislative majority to force the passage of an amendment to the National Health Insurance Act (全民健康保險法) intended to resolve chronic budget deficits. The introduction of the national health insurance (NHI) program in 1994 was a milestone in the nation’s history of public health and there is widespread agreement that something must be done to keep the program afloat.
So, why do opposition legislators contest the proposed changes? Because many feel they do not address inequities long recognized in the system that allow wealthy Taiwanese to avoid paying premiums on significant amounts of their earning. While the new plan will generate the increased revenue needed to support the NHI, critics charge that this will be done not by correcting the system’s inherent unfairness, but by having those who pay now, pay more.
Ironically, the administration of President Ma Ying-jeou (馬英九) agrees with this view. The proposal originally put forward by the Department of Health resolved both problems, and by doing so received support from the Democratic Progressive Party (DPP). Yet what should have been a happy outcome for both parties and the country failed when it occurred to some KMT legislators that it would be politically risky to deny those who benefited from the original law. So, without a squeak from the president, Premier Wu Den-yih (吳敦義) and his Cabinet abandoned the original proposal in favor of the one that will be passed tomorrow, the main aim of which is to avoid taking a stand on anything.
This seems to be the Ma administration’s agenda for everything over the next two years: Don’t rock the boat. Drift, sign everything China puts on the table and hope that the absence of open hostility across the Taiwan Strait buoys the economy sufficiently to win the presidential election next year.
A government with a supermajority in the legislature should be a very hard boat to rock, which raises questions about the leadership of the administration that are not new by any means. Ma might learn something from US President Barack Obama, who committed so much political capital to a healthcare bill that was extremely difficult to pass and may well cost him in the future.
Political expediency is not why he acted, however. It was, in his words, “the right thing to do,” which is to say, the right thing for the country as a whole, not the right thing for him, for his party or for the wealthy, whose healthcare bills will be paid in any event.
Taiwan faces many difficult decisions, some looming and some that have been put off for far too long. These include other problems of fairness and public finance: income tax reform, property tax reform and tax redistribution related to the five special municipalities. The decisions that need to be made will be painful, but continuing to avoid them only invites the kind of fiscal disaster that threatens European nations that allowed bond markets to finance their debt.
No less painful will be solutions to cultural and political problems, as well as those having to do with public welfare, judicial reform, constitutional reform, the aging population, the growing gap between rich and poor, education and defense. Many of these also come with hefty price tags — political and economic — and no governments worried about the next election relish the job of coming up with the resources to pay.
However, pay we must, and while Ma seems to enjoy holiday weekends like the one just past when he can shake hands, kiss babies and pretend he is once again mayor of Taipei, he might recall what an analysis by the Hong Kong-based CLSA financial group said last year, which is that next year’s presidential election is the KMT’s to lose.
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