Whenever the Ministry of Health and Welfare releases a salary survey of nursing staff claiming annual salaries of NT$700,000 to NT$800,000 (US$22,097 to US$25,254), nurses across Taiwan roll their eyes. The enormity of the gap between official data and reality is not a simple statistics error, but a kind of gaslighting. The message to those in the wards is clear: If you do not have money, it is because you have not worked enough night shifts and you have not pushed yourself, which is why you have not received the performance bonus.
What is the reality of nursing care in Taiwan? It is jogging down ward corridors while holding your bladder, wolfing down a few cold mouthfuls of food to save time on lunch breaks and looking at your savings account after work, asking why you took on this stress.
In Taiwan, the NT$32,000 to NT$36,000 base salaries of full-time nurses are comparable to that of a management trainee in a chain restaurant. The so-called “high salaries” touted by the ministry are earned entirely by working graveyard shifts, which require sacrificing family life and ignoring biological clocks. Once the health of such nurses collapses and they can no longer work night shifts, their salaries drop back to square one.
This is not a professional bonus; it is trading years of your life for cash.
Even more concerning is that while hospital operators constantly bemoan being short of funds, their financial statements tell a different story. In 2023, Linkou Chang Gung Memorial Hospital reported an annual surplus of NT$5.6 billion, while China Medical University reported NT$3 billion. These so-called “non-profit” medical foundations invest the surpluses in new buildings, expensive new equipment and expanded operations.
In their capital-driven calculations, physical assets can appreciate in value, while nursing staff is a cost to be minimized. When hospitals generate hundreds of millions in surpluses yet fail to ensure that nurses’ salaries keep up with inflation, it is not an exaggeration to call it a structural program of enriching the well-off at the expense of the poor. In the face of such exploitation, the government’s role should be that of final arbitrator. Clearly, it has chosen to side with capital.
The ministry has not dared to confront the issue directly and disrupt the hospitals’ profit structure as it could have done, for instance by mandating that nursing fees go to the nurses themselves, or legislating for a minimum nurse-patient ratio of three to one. Instead, they have opted for a far more roundabout and damaging route: introducing foreign nursing staff and intern nurses who are yet to even pass the national exam for nursing personnel.
The government has allotted NT$2.5 billion for such endeavors, preferring to turn to cheaper labor rather than ask hospitals to dedicate a share of their profits to improving the conditions and salaries of nurses.
To frontline staff, this is not just a policy error, but an abasement. It sends the message loud and clear that, in the government’s eyes, nurses are nothing more than replaceable units on the assembly line. With foreign nurses lacking language skills entering the workforce, communication gaps and oversight responsibilities eventually fall back on on the shoulders of already overworked nurses, making systems that are already stretched thin even more chaotic.
We have witnessed successive waves of nurses fleeing the profession, switching to careers in cosmetic surgery, insurance or even selling coffee. It is not for a lack of passion for their work, but because the system has made staying nearly unbearable.
Taiwan’s “miracle” of a healthcare program has long been built on the blood, sweat and tears of nursing staff. To maintain cheap healthcare and the stable profits of hospital conglomerates, the government has tacitly condoned this chronic persecution of the nursing profession. If its policies continue to ignore the systemic greed at large and use foreign labor to plug gaps, then the collapse of the entire system is only a matter of time.
Treating nurses as disposable, at the end of the day, comes at the expense of each and every Taiwanese in need of medical care.
Able is a graphic designer.
Translated by Gilda Knox Streader
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