An overhaul of a health insurance system is a major undertaking in any country. This is because national health insurance systems involve the welfare of every citizen — present and future. As all eyes focus on the legislative review of the hotly debated amendments to the National Health Insurance Act (全民健保法), Department of Health Minister Yaung Chih-liang (楊志良) is trying to get the second-generation health insurance through, despite the obstacles that remain.
The reforms need to address several major issues, such as the fee base, a new insurance premium system, varying levels of payment and the black hole caused by the price of medication. However, the Cabinet-approved draft only addresses the expansion of the fee base and proposes that single people and DINKs (double income, no kids) pay more. In addition, the plan makes no mention of how to reduce the waste of resources. No wonder Democratic Progressive Party legislators have objected to it. What’s more, the draft hasn’t even garnered the full support of Chinese Nationalist Party (KMT) lawmakers.
Even if the draft passes, the reform efforts would be a failure because several crucial issues would remain unresolved.
The first issue is fairness. The premium would be based on household income, not population, in order to expand the fee base. Everyone with an income is liable, but the new system would only take into account income from salaries, interest and dividends, but not from capital gains, property and stock speculation, pensions or overseas income. In what way is this fair, reasonable or just?
The second issue is whether these reforms even make sense. Premiums would no longer be calculated on the number of dependents in a household, and would instead be based on total household income. The correct way to calculate the health insurance premium is simply related to how much will be paid on settling claims, and has nothing to do with one’s income, job, marital status or the number of kids.
The two major criteria that affect how much is to be paid are the rate of usage of medical treatment and inflation. The latter is beyond the control of health insurance policy or legislators and depends on the rate of economic growth and commodity prices. The usage rate, however, which is strongly related to the rate of premiums, can be controlled by the cost of treatment provided. The Bureau of National Health Insurance has allowed the waste of medical resources to spiral.
The third issue is distributing the burden. The provision of medical treatment has direct implications for patients’ health, recovery prospects and prognosis, and people should be able to pay however much they want. Not all prescription drugs cost the same. The basic principle is that patients who use branded prescription drugs pay a little more, while those using generic drugs pay less. However, this is not the main point: The department has not addressed the main issue. While it is fine to give patients the option of paying more for different levels of medical treatment, the same thing should not apply to prescription drugs. This is clearly a retrogressive compromise that flies in the face of expert opinion.
Finally, there is the financial black hole. Expenditures on prescription drugs takes up a quarter of total annual costs, with more than NT$120 billion (US$4 billion) spent on drugs every year. This is hospitals profiting through the abuse of premiums. If this problem isn’t addressed, the waste will continue.
The government is aware that healthcare reforms implemented by US President Barack Obama contributed to his drubbing in the recent midterm elections and it waited until the five special municipality elections were over before it pushed to get the health insurance reform process passed by the legislature. However, if these reforms fall short of public expectations, the government will pay the price in the 2012 presidential elections.
As China steps up a campaign to diplomatically isolate and squeeze Taiwan, it has become more imperative than ever that Taipei play a greater role internationally with the support of the democratic world. To help safeguard its autonomous status, Taiwan needs to go beyond bolstering its defenses with weapons like anti-ship and anti-aircraft missiles. With the help of its international backers, it must also expand its diplomatic footprint globally. But are Taiwan’s foreign friends willing to translate their rhetoric into action by helping Taipei carve out more international space for itself? Beating back China’s effort to turn Taiwan into an international pariah
Typhoon Krathon made landfall in southwestern Taiwan last week, bringing strong winds, heavy rain and flooding, cutting power to more than 170,000 homes and water supply to more than 400,000 homes, and leading to more than 600 injuries and four deaths. Due to the typhoon, schools and offices across the nation were ordered to close for two to four days, stirring up familiar controversies over whether local governments’ decisions to call typhoon days were appropriate. The typhoon’s center made landfall in Kaohsiung’s Siaogang District (小港) at noon on Thursday, but it weakened into a tropical depression early on Friday, and its structure
Since the end of the Cold War, the US-China espionage battle has arguably become the largest on Earth. Spying on China is vital for the US, as China’s growing military and technological capabilities pose direct challenges to its interests, especially in defending Taiwan and maintaining security in the Indo-Pacific. Intelligence gathering helps the US counter Chinese aggression, stay ahead of threats and safeguard not only its own security, but also the stability of global trade routes. Unchecked Chinese expansion could destabilize the region and have far-reaching global consequences. In recent years, spying on China has become increasingly difficult for the US
Lately, China has been inviting Taiwanese influencers to travel to China’s Xinjiang region to make films, weaving a “beautiful Xinjiang” narrative as an antidote to the international community’s criticisms by creating a Potemkin village where nothing is awry. Such manipulations appear harmless — even compelling enough for people to go there — but peeling back the shiny veneer reveals something more insidious, something that is hard to ignore. These films are not only meant to promote tourism, but also harbor a deeper level of political intentions. Xinjiang — a region of China continuously listed in global human rights reports —
RSS