Wed, Jul 04, 2018 - Page 8 News List

Subsidy not the solution for birthrate difficulties

By Tsai Ping-hsun 蔡秉勳

The Executive Yuan has drafted a series of policies to boost the birthrate, one of which is to provide parents of children up to two years old [who hire babysitters or send their children to daycare centers] with a monthly subsidy ranging from NT$6,000 to NT$10,000 to pay for childcare. On Wednesday last week, Premier William Lai (賴清德) decided that the subsidy would be distributed directly to parents. The policy is expected to go into effect on Aug. 1.

Putting aside the rationale of using financial incentives to boost the low birthrate, it is doubtful that the monthly subsidy will be sufficient to alleviate the issue; otherwise the low birthrate problem would not have worsened in many other nations where this policy has already been tried.

As part of a wider global trend, the low birthrate is unlikely to change in the short term, but the government’s mindset can. Officials should pay more attention to children and make more effort to ensure that they grow up in a healthy environment, as more healthy children would lessen the impact of the low birthrate. Enhancing the health and welfare of children is the best policy to counter the low birthrate problem.

Taiwan ranks fifth against Organisation for Economic Co-operation and Development member nations for infant mortality rates. Taiwan’s relatively high mortality rate for children younger than one reflects an imbalance in the distribution of medical resources. Aside from accidental deaths, a lack of comprehensive medical care is the leading cause of infant mortality: 45 percent of deaths result from congenital anomalies and disorders originating in the perinatal period of premature births.

The low birthrate has led to a reduction in the number of patients in pediatrics wards and the size of the medical market for children’s health. Naturally, hospitals are budgeting fewer resources to pediatric departments, which in turn become less attractive to newly graduated doctors. The doctor-patient ratio in pediatrics stands at one physician for as many as 4,000 children, which is hardly sustainable.

Waiting times for surgery for young patients are getting longer and the quality of treatment has been affected. In the long term, the phenomenon will lead to the insufficient quality and quantity of pediatricians and inadequate medical training. Children in need of emergency or critical care will suffer the most, as such conditions require copious resources and long hospitalization. Many of these patients could fully recover and grow up to become healthy, but will die young due to a lack of medical resources.

In 2016, the Ministry of Health and Welfare launched a project to enhance the quality of pediatrics and integrate medical resources across regions. Subsidies were given to 15 counties and municipalities to hire additional pediatricians for emergency departments. However, the number of regions lacking emergency care pediatricians did not decrease. Few concrete measures have been implemented or are planned to tackle the issue.

It is welcome that the government has shown a determination to raise the birthrate, but giving out money alone will not make much difference. It needs to plan and implement support measures, such as coordinating resources for child medical care, while tackling underlying social issues, such as low pay and rising housing prices, and establishing more affordable childcare facilities.

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