Taiwan launched its first 10-year long-term care program in 2007, followed by long-term care 2.0 in 2017. Its latest reincarnation, long-term care 3.0, was brought forward to be launched ahead of schedule this year. Over the past 19 years, these initiatives have provided older people with localized care services. Despite high public approval ratings, it is still felt that the program struggles to meet the care needs of people with more severe dementia or disabilities who require professional support.
With longer life expectancies, falling birthrates and an aging population, the traditional arrangement of large multigenerational households has turned into “beanpole” families with a smaller extended family network. With older people requiring care for longer periods and fewer caregivers to provide it, this sustained pressure has even led to cases of abuse. Dedicated care services are needed, but the associated costs are beyond the scope of the government’s general long-term care budget as it stands.
It is for this reason that the social welfare sector hopes to see the Legislative Yuan review and pass legislation for a transition to an insurance-based model for long-term care, following the examples of Japan’s and South Korea’s systems, which require every citizen aged 40 and older to pay into. Pooling the resources of these annual insurance payments could work to ensure the fiscal stability and sustainability of the long-term care services system, providing much-needed support for older people and alleviating the burden on caregivers.
At present, legislators from across party lines have proposed a draft act for long-term care insurance. They have noted that for the long-term care system to be comprehensive and sustainable, it would require sound mechanisms to secure sufficient funding, for example, through a long-term care social insurance scheme. Under the proposal, long-term care insurance would coexist with the National Health Insurance (NHI) system under a dual-track model. Enrollment would be based on NHI status, and insurance premiums would be split equally between individual, employer and government contributions. The premium rate would be set at 1.19 percent for the first three years, after which the rate would be actuarially reviewed every three years.
In addition to the rollout of long-term care insurance, promoting active aging is also essential. This means encouraging older people to retain their energy and capacity to contribute to society after retirement, continue actively participating in productive or public-interest activities, and remain socially engaged rather than withdrawing from public life. This approach seeks to overturn the traditional mindset that views retirement as a period of idle leisure at home, caring for grandchildren and disengaging from social affairs.
Beyond social participation, older adults should maintain a positive outlook and grounded mentality in their lives during retirement. Doing so can reduce the risks of dementia or disability, which would lessen the load on caregivers. This is exemplified by the Nordic “aging in place” policy model, which seeks to enable older people to remain in their homes and communities, and be as active as possible toward the end of their lives. The goal is to help people live well and with dignity.
Old trees require new branches just as much as those new branches rely on the trunk. Promoting long-term care insurance for financial sustainability and active aging for continued social contributions are not only acts of care for today’s older generations, but a safeguard for everyone’s future. It is through this sense of generational continuity and compassion that humanity can shine bright.
Chen Chien-hsien is chairman of the Taitung County Sports Development Foundation and an assistant professor in Meiho University’s Department of Social Work.
Translated by Gilda Knox Streader
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