Some lawmakers have said, in a self-mocking tone, that their constituent services now cover everything in life, from the cradle to the grave.
Why are people asking their representatives to lobby for time slots to cremate a body? Lawmakers say the government has promoted cremation over burial and banned bribery in the funeral business, but people are still influenced by the superstitious tradition of choosing an “auspicious hour” for when people come into and leave the world.
In metropolitan areas, where public funeral houses are administered by local governments, such services are transparent and cremation schedules are made public in advance.
Under such circumstances, it is difficult for publicly elected officials to intervene, and lawmakers often have to say: “Sorry, I can’t help you” to their constituents when they ask for help securing an ausicious time slot for a cremation.
According to one lawmaker’s assistant, the representative receives dozens of requests a year for favorable cremation slots, but the lawmaker only helps about half because some funeral parlors cannot agree to “special requests.”
An even greater number of requests are made each year to help people get a hospital bed — either in an emergency room or an ordinary room — or to schedule surgery. Sometimes, a patient’s family requests help in moving a patient from a room in one department to another.
Lawmakers say they receive these requests when the hospital tells their constituents that no beds are available. Even when a patient is assigned to an emergency ward, the family does not know when a normal hospital bed will become available.
“This is the reason people request help in getting a bed in a hospital. The hospital should design a system to tell people, in a more transparent way, when they will get a bed,” said one lawmaker, who declined to reveal his name.
Crowding is not limited to services for the sick and the recently deceased. The nation’s declining birthrate has not helped free up openings in hospitals for deliveries. Gynecological services are distributed unevenly because of manpower problems in hospitals in rural and in urban areas.
Taiwan Association of Obstetrics and Gynecology secretary-general Huang Min-chao (黃閔照) said many parents-to-be prefer to have their babies born in a large hospital, leaving smaller or rural hospitals without many -opportunities to deliver babies.
For example, the three gynecologists at Cathay Hospital in Hsinchu need to deliver 250 babies a month — a work rate that is almost beyond the doctors’ abilities. To make matters worse, the hospital does not have enough beds for child-bearing mothers.
Huang’s association said 43 percent of rural hospitals did not have a single gynecologist, while 60 percent could not arrange for one to help give birth.
Huang said the lack of incentives under the national health insurance program for childbirth services and the high frequency of medical disputes in this medical discipline have driven down the number of physicians who choose to become gynecologists.
As a result, the association is thinking of promoting a Japanese-style “pre-registration” system, under which a pregnant women is given a “new mother’s manual” that tells her to go to a certain hospital for regular check-ups during pregnancy.
Medical Affairs Bureau of the Department of Health director Shih Chung-liang (石崇良) supported the association’s idea, calling it “very feasible” because childbirth is not an emergency, but something that can be planned.
Taiwan’s hospitals are often crowded not just for childbirths, but also for surgical procedures. One reason, again, involves the tradition that the lunar month of July — “ghost month,” which begins on Aug. 17 this year — is not considered a good time to go under the knife.
The superstition puts pressure on hospitals to perform more surgeries ahead of ghost month, leaving doctors extremely busy.
Compared with this “seasonal” uptick in requests for operations, the overcrowding in hospitals’ emergency wards is a year-round phenomenon.
Chu Hsien-kuang (朱顯光), head of R&D at the Taiwan Healthcare Reform Foundation, said some major hospitals receive so many emergency care patients that they have to “seize” ambulance stretchers as beds — and stop ambulances from bringing in more patients.
Chu said emergency rooms are overcrowded partly because patients without urgent needs, who have failed to make a clinical appointment for weeks, simply turn up and use the emergency room as a service that “costs just a bit more than usual” to get a prescription.
He said hospitals should screen out such patients and treat them as non-urgent cases to ease the burden of medical workers at emergency wards.
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