Wed, Dec 02, 2015 page8

• EDITORIAL: Long-term care needs united effort

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  The Long-Term Care Services Act (長期照護服務法) cleared the legislature earlier this year, but with a source of funding still undetermined, it looks like an empty gesture. The two major political parties have been exchanging barbs over how the money should be raised, with the Chinese Nationalist Party (KMT) pushing for a long-term care insurance system that would turn every taxpayer into a policyholder, while the Democratic Progressive Party (DPP) is calling for raising sales, inheritance and gift taxes.

  Sufficient funding is the crux of a workable long-term care system, but is the source of the funding really what should be at the heart of the debate?

  When KMT presidential candidate Eric Chu (朱立倫) on Monday said the DPP’s funding method would only provide NT$3,500 per person per month and the DPP said the KMT’s plan is “tantamount to levying extra taxes,” they dragged people into an inane discussion that misses the point.

  First, even if NT$3,500 per person is not enough, the issue does not address the difficulty of the system at all. Doubling or tripling that amount would still not pay for services if people have no trustworthy long-term care provider nearby, especially in remote areas.

  The DPP’s challenge sent a misguided message that long-term care services do not require contributions from the public. A defense might be that what the DPP envisions is taxing wealthy people, which could serve to aid the redistribution of wealth.

  However, money alone cannot make long-term care universally accessible and affordable.

  The KMT calls for “diversity of services” — affordable or “refined” — by introducing for-profit organizations into the field, while talking about “government supervision” when met with doubts of possible stratification and commercialization of services.

  Besides, the unending food safety scandals of recent years puts in doubt the competence of the government to oversee private operations concerning public welfare.

  There are the examples of South Korea and Japan, where academics say the introduction of for-profit companies into the market has brought problems such as repressed wages for caregivers, low-quality services from over-competition and sufficient, but uneven, distribution — and even forgery — of records to receive government payments.

  The DPP needs to expound on how the government could spread the public network of long-term care services without the help of for-profit enterprises when the most serious setback existing services encounter is a lack of personnel — professional caregivers and systematic training for them — and an over-reliance on exploited, low-paid migrant workers.

  That Taiwanese are disinclined to send elderly family members to institutions — with government statistics indicating that there is an excess of beds in its institutions — demonstrates the need for home-based and community-based services, which could not only take care of those who are heavily dependent on others, but also provide preventive care for elderly people who are not severely disabled.

  Establishing a network that takes into account accessibility, cost and quality without exploitation would need the input of various ministries and both central and local governments. More importantly, it requires the resolve of the central government to ensure a coordinated and united effort, rather than allowing for a ramshackle, Potemkin-village-like policy of planning and spending, which is pretty much what is happening now, years after the advent of the nation’s first plan for the construction of a public long-term service system.
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