Every once in a while, stories emerge about murders in connection with people caring for sick or aging family members at home. These always seem shocking, but they are not followed up by actions to revamp the nation’s social welfare policy, especially in long-term care.
The most recent case was a 21-year-old man, who had suffered from cerebral palsy since he was three years old. He was chocked to death by his 41-year-old father. The mother and father of the victim support a family of elderly parents and a second son in his teens. The father phoned the police one hour after he killed his son and was found cuddling his son’s body in the rear seat of his vehicle crying loudly in despair. He told the police that he does not want to live anymore.
The father did not provide around-the-clock care for the victim, who attended a special education school in the daytime and was looked after by his grandparents at night during weekdays. Even so, due to the immense stress over decades of dealing with the needs of the family, the father had a breakdown.
There have been other similar tragedies over the years: A woman turned herself in to the police after she smothered her chronically ill mother-in-law to death with a pillow in 2009; an old man hammered a screwdriver into his wife’s forehead to end her suffering in 2011; a man shot his physically challenged younger brother and killed himself after he was diagnosed with cancer in 2012, because he wanted to spare his family the pain of taking care of them. Incidents like these are too numerous to mention.
Such situations might have been avoided if Taiwan had had an adequate system in place.
According to the Ministry of Health and Welfare, the number of people with chronic illnesses or disabilities who need assistance with daily activities stands at 710,000.
Among them, only 7 percent are provided with limited resources under the 10-year long-term care project the government launched in 2007, receiving subsidies covering home nursing care and rehabilitation as well as acquisition or rental of auxiliary appliances, provisions of meals and other institutional services. About 28 percent are looked after by migrant workers, while 65 percent are taken care of by family members. Only 3,000 out of the about 200,000 elderly people with dementia are covered by social services.
The 10-year long-term care project is due to terminate at the end of next year, but the ministry’s plan for a long-term care insurance act is still awaiting approval from the Cabinet, and bills aimed to establish long-term care services are under legislative review, with the main issue being how to secure a stable source of funding for the services.
Recently, the Executive Yuan put aside the proposed insurance project after the Ministry of Finance expressed concerns that the project would require the government to fund at least 36 percent of the annual budget needed in the early stages of its implementation, and leaders of business groups voiced opposition to the proposed share of premiums between the employers, employees and the government of 60 percent, 30 percent and 10 percent respectively.
The draft long-term service care act is aimed at the regulation and management of service suppliers rather than addressing insufficient supply. Even if the act passes the legislature, it alone would not do much to increase the provision of basic and affordable long-term care if the government fails to inject funds to train domestic caregivers and to provide more institutional or community-based services to meet a rapidly growing demand.
Creating a long-term care service network is a must and it cannot be achieved without taxation reforms to generate the required revenue.
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