The Ministry of Health and Welfare announced recently that next year it will introduce a policy involving subsidizing assisted reproduction for infertile couples to increase Taiwan’s fertility rate.
Giving subsidies to economically disadvantaged, infertile couples to help them have children is a great idea. However, the main reason behind the declining birth rate is not infertility, but rather that potential parents cannot afford to raise children.
While assisted reproductive technology has become increasingly advanced in Taiwan over the past decade, the average live birth rate per embryo transfer cycle has remained at a mere 27 percent, which means that on average, an infertile couple will have to go through three or four rounds of therapy before the process is successful.
Therefore, the government has drawn up a three-year budget of NT$940 million (US$31.4 million) for artificial reproduction subsidies, of which almost NT$670 million will be spent on failed therapies, which is hardly cost-effective.
Furthermore, the ministry has forecast that 4,000 children will be born three years after the policy is implemented and that for each child born, an average of NT$235,000 will have been paid out in subsidies.
Given the government’s substantial debts and that such debt is passed on from one generation to the next, it seems somewhat inappropriate and unreasonable of the government to spend tax revenue in this way.
The ministry believes that the government’s seven major policies aimed at tackling the declining birth rate have been effective enough to create a positive environment in which people can rear children and all that is required now is for people to start having babies.
Yet the current social welfare system only partially subsidizes child care and medical care, while the government has no clear plans for subsidizing the daily necessities for raising children that need to be covered by parents, such as clothing, food and living expenses.
Thus, this is a policy that looks good on paper, but that provides no real benefits. The result will be that those who cannot afford to have children are less likely to apply for the subsidies, while those who are better off and can afford to raise children will be the only ones with the means to apply each year, which will cause a negative distribution of government funding.
In addition, because of the economic incentives, doctors might be inclined to encourage younger couples to try artificial reproduction — citing the higher success rates in younger couples — discouraging the natural process of pregnancy in favor of medical procedures, which expose both mother and child to the risks involved in assisted reproduction.
Policies aimed at assisting the economically disadvantaged have always been of high importance, but the government’s ideas about the nature of artificial reproduction and child rearing are impractical.
Without carrying out a complete cost-effectiveness analysis or a social impact assessment of these policies and putting them into practice before the next presidential election, the only thing to be certain of is that within the next three years, 74 medical centers for assisted reproduction will gladly take both the NT$940 million that the government will give them and all the business opportunities this might create.
Huang Sue-ying and Tsai Wan-fen are president and secretary-general respectively of Taiwan Women’s Link.
Translated by Drew Cameron
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