There is no absolute relationship between the relative urgency of a plan and whether it should go through the PDCA procedure. One of the best policies in Taiwan is the HIV/AIDS harm reduction program for drug users that the health ministry launched a few years ago. It took just a year to draw up the plan, after which pilot schemes were launched in selected cities and counties. Assessments showed that the program brought about significantly larger reductions in new drug-related HIV/AIDS cases in the pilot areas — Taipei, Taoyuan County and the then-Tainan County — than in areas without the schemes. Based on these results, it was decided after a year of trials to implement the program nationally. As a result, new HIV/AIDS cases plunged to about half the previous level in just two years.
However, hastily thought-up policies — even major policies — are the rule in Taiwan, while precious few are implemented according to the proper procedure. The riskiest major policies that Taiwan has adopted are the National Health Insurance scheme and the Taiwan High-Speed Rail. Neither of these major national policies was subjected to strict pilot evaluations at the initial stage of implementation.
Perhaps it is because so many Taiwanese burn incense for good fortune that these two policies have turned out to be major successes, but that is just luck and you cannot count on luck every time. In the future, public policies must go through strict pilot-scheme assessments before they are implemented.
All government ministries need departments dedicated to implementing and assessing policy pilot programs. These departments would be responsible for all the policies that ministries plan on bringing into play. If this lesson is learned, Taiwanese who have been lab rats for government experiments like the eTag and household registration systems will not have done so in vain.
Wang Jen-hsien is president of the Taiwan Counter Contagious Diseases Society.
Translated by Julian Clegg