The nine-in-one elections on Nov. 29 are unprecedented in that they are to involve the elections of 11,130 local government officials. Why do democratic countries hold local government elections? Have the polls held over the years and the advancement of local autonomy led to a better provision of residents’ basic day-to-day needs?
On Monday, the “flipped election movement” (翻轉選舉運動) launched by youngsters and students who played an active part in the Sunflower movement, along with civic group leaders, presented a comparative analysis of the provision of five basic day-to-day needs — healthcare, running water, public transport, public childcare and social assistance — in the nation’s 22 counties, cities and municipalities. The report reveals a high degree of disparity between these regions.
With regard to healthcare, as of the end of last year, there were 36.15 doctors for every 10,000 people in Taipei, which can be said to have the most plentiful healthcare resources among all regions. By this measure, Kinmen County had the least healthcare resources, with 6.05 doctors per 10,000 people. It was preceded by Hsinchu County with 9.41, Miaoli County with 11.53, Taitung County with 13.66, Yunlin County with 14.28, New Taipei City with 14.30, Chiayi County with 14.34 and Nantou County with 14.50.
Apart from New Taipei City, whose residents can seek treatment in Taipei, the seven other regions are not special municipalities. This shows that basically there is a hierarchical distribution of healthcare resources, with Taipei at the top, followed by the five other special municipalities, and then other cities and counties (including Keelung City, which is not a special municipality).
The unequal distribution of healthcare resources obviously makes it harder for people in some places to obtain medical treatment. Beyond that, it has a substantial impact on health and quality of life. A comparison of the figures for life expectancy and accident mortality in the eight regions with the lowest ratio of doctors reveals that, apart from New Taipei City and Kinmen County, the six other regions all rate low in these areas.
The life expectancy for people living in these six regions are between 8.34 years and 3.75 years lower than Taipei’s 82.9 years, ranging between 74.66 for Taitung County and 79.15 for Hsinchu County. These six regions’ accident mortality rates are between 3.79 and 2.08 times higher than Taipei’s 17.2 deaths per 100,000 people, with the highest being 65.2 for Taitung County and the lowest, 35.7, for Hsinchu County. The fact that Taitung County residents live an average of eight years less than Taipei residents is particularly shocking and worrying.
As for the provision of running water, Taipei is nearly 100 percent covered, compared with less than 50 percent for Pingtung County and less than 80 percent for Nantou, Miaoli and Taitung counties.
Although this situation cannot be ascribed entirely to the performance of local government leaders, it is to be hoped that candidates in these regions can respond by coming up with proposals about how to promote regional parity in these five areas. This would include an explanation of how they intend to improve situation, within the limits of their powers, at the city and county level.
Beyond that, we need to work out what changes should be made in the overall structural relations between the central and local governments with regard to national land planning, regional upgrading, the distribution of financial revenue and expenditure and the powers of special municipalities, other cities and counties, so as to better provide for people’s basic day-to-day needs.
Lai Chung-chiang is a founding member of the flipped election movement.
Translated by Julian Clegg
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