The COVID-19 outbreak in China has renewed the debate over whether Chinese should be allowed to use the National Health Insurance (NHI) system.
Much of the controversy centers on a Taiwanese teenager who has hemophilia and lives in Wuhan, China, the epicenter of the outbreak, with his mother, a Chinese who obtained Republic of China (ROC) citizenship through a previous marriage.
Just as the teenager ran out of medication for the disease, the Taiwanese government sent a flight to Chengdu, China, to bring the mother and son to Taiwan, where he has since been on steady medication.
The source of controversy was a decision made by the administration of former president Ma Ying-jeou (馬英九) in 2015 that relaxed the rules on Chinese citizens’ eligibility for the NHI system by broadening the scope of resident certificates to include entry permits awarded to Chinese who are married to Taiwanese or are in the nation “visiting a relative.” The move was a clear violation of due legislative procedure and widely panned as overstepping the National Health Insurance Act (全民健康保險法). It also means that Chinese enjoy the same healthcare benefits as Taiwanese as long as they are given a residency certificate for visiting their Taiwanese step-parent.
According to statistics compiled by the National Health Insurance Administration, about 63,000 Chinese benefited from the rule change in 2015, which in turn increased NHI expenditure by NT$31.5 million (US$1.05 million at the current exchange rate).
In the wake of the controversy, lawmakers in the pan-green camp have issued calls for the rule to be abolished or amended, with Democratic Progressive Party (DPP) Legislator Wang Ting-yu (王定宇) and Taiwan Statebuilding Party Legislator Chen Po-wei (陳柏惟) vowing to close the loophole in the NHI system created by Ma’s administration.
Meanwhile, DPP Legislator Lin Chun-hsien (林俊憲) recommended amending the act to raise the NHI premiums for those who do not live in the nation for at least 183 days annually.
He proposed that the NHI rates for these people be set in proportion to their annual income overseas, which could see the monthly premiums of high-income earners raised from NT$749 to NT$12,000 — the highest possible rate under the insurance system in the absence of premium allocations from a local employer or the government.
The proposals to rectify the problem deserve praise, but with the DPP having been the ruling party for almost four years, such calls are long overdue.
Any government would adopt a hardline stance if a lobbyist called for a person of another nationality to enjoy the same social welfare as its citizens, so it makes no sense for Chinese to use the NHI just because they are visiting a relative and need an extended stay in the nation.
It defies the logic of any sensible government, and if any Chinese had thought about exploiting this rule, they would have succeeded if Minister of Health and Welfare Chen Shih-chung (陳時中) last month had not overturned a Mainland Affairs Council policy that would allow the Chinese children of Taiwanese and Chinese couples to return from China.
The Mainland Affairs Council in the frequently asked questions section of its Web site states that any Chinese spouse who has not renounced their People’s Republic of China citizenship will have their ROC citizenship rescinded, so the debate of whether Chinese should be allowed to use the NHI is a non-starter, and should be responded to with a resounding “no.”
With Premier Su Tseng-chang (蘇貞昌) and DPP caucus whip Ker Chien-ming (柯建銘) having clarified their stance for amending the rule, it is down to President Tsai Ing-wen (蔡英文) to give the legislative effort the go-ahead.
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