Not long ago, newspapers reported that the total expenditure of the National Health Insurance (NHI) system had for the first time exceeded NT$700 billion (US$23.17 billion), but its deficit might be as much as NT$50 billion to NT$60 billion. If the situation continues to worsen, Taiwan’s NHI program would go bankrupt in 2021, according to National Health Insurance Administration data.
When a nation becomes a “super-aged society,” as the number of elderly people increases while the population shrinks, healthcare costs are sure to keep rising as more people get sick and develop acute and serious illnesses. The trend for NHI expenditure to keep climbing is to some extent irreversible, but is it unavoidable?
It is possible to focus on prevention, health promotion, public hygiene and chronic disease control and prevention to hold the healthcare front line, rather than waiting until after people have fallen ill and must seek medical treatment, which would increase NHI expenditure even more.
The main problem is sugar consumption. Sugar is public enemy No. 2, after tobacco. The only difference between the two is that it is possible to avoid tobacco, while sugar is inescapable.
Two of the main sources of sugar that does not occur naturally in fruits and vegetables are soft drinks and energy drinks. It is also an ingredient in bread, yogurt, peanut butter, soup, wine, sausage and almost every other processed food.
Studies have shown that sugar is harmful to our physical health. In addition to being the primary culprit behind obesity and diabetes, increasing the risk of cardiovascular disease and metabolic syndrome, Academia Sinica research also shows that high sugar consumption contributes to pancreatic cancer.
In January 2014, Mexico added a 1 peso (US$0.05) per liter tax on sugary drinks, which reduced sugary drink purchases by 7.6 percent during 2014 and 2015, a study from the Mexican National Institute of Public Health and the University of North Carolina showed.
After France taxed soft drinks in 2012, the consumption of these drinks went down, while Norway has had a generalized tax measure on refined sugar products since 1922 and is achieving good results with its consumer information program.
In 2016, the British chancellor of the exchequer announced a sugar tax targeting manufacturers and importers, based on a product’s sugar content. In 2017, Philadelphia introduced the Philadelphia Beverage Tax, which targets distributors of sweetened beverages and caused sales of sweetened drinks in the city to fall by 38 percent.
Ministry of Education data show that about 30 percent of elementary and junior-high school students are obese, and this number is increasing. World Obesity Federation information shows that the obesity rates among adults and children in Taiwan are Asia’s highest behind China.
The government should learn from the experiences of other countries, and in addition to writing new laws, raising business tax on sugar-related businesses and supervising the food industry, it should educate people and help them protect themselves. If nothing is done, national healthcare will pay a heavy price.
Wei Shih-chang works in the information industry.
Translated by Julian Clegg and Perry Svensson
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