The third problem stems from the fact that services may not be available as needs arise even if one does purchase insurance. A list of services provided by the Life Insurance Association of the Republic of China mentions three types of care services and their prices. The first is home healthcare, which includes care given by foreign and Taiwanese nursing aides. The second type is community-based services, such as daycare centers, and the third is services offered by special care facilities. What the association does not tell consumers is where they can receive these services after they buy insurance. This is an issue related to the popularization or accessibility of these services, affordability and quality.
The truth of the matter is this: First, last year there were fewer than 10,000 Taiwanese nursing aides or homecare attendants providing services to fewer than 40,000 people. The average age of these aides was almost 50. Second, as of last year, there were fewer than 100 daycare centers nationwide for people with mild disabilities or dementia, offering services to fewer than 2,000 people. Eight cities and counties do not even have one daycare center. Third, as of last year there were a total of 1,057 special care facilities nationwide, but fewer than 50,000 people used these services, giving these facilities a utilization rate of only slightly more than 70 percent.
In terms of quality, for senior citizens’ welfare institutions inspected and assessed by the government between 2009 and 2011, we see that in Taipei, only 64 percent of 121 facilities scored an “A” rating, while only 52 percent of Kaohsiung City’s 128 facilities achieved this grade. Out of the 38 districts of the new Greater Kaohsiung municipality, a total of 14 did not even have one special care facility for elderly people. With Taiwan’s two oldest and richest special municipalities in such a bad state, what can be expected for other cities and counties?
Foreign aides are the largest providers of LTC services. Last year, there were more than 200,000 such aides, of whom 150,000 came from Indonesia. However, Indonesia has said it will stop exporting workers by 2017. So, if Taiwan does not establish LTC services soon and train more care workers, fails to carefully plan public LTC insurance and only provides tax deductions for such care, how can we expect to minimize the risks LTC will face in the future?
Wang Pin is an assistant professor of social work at National Taipei University.
Translated by Drew Cameron