Five medical associations yesterday slammed a proposed amendment to the Senior Citizens Welfare Act (老人福利法) that would exempt people older than 65 in a low tax bracket from paying National Health Insurance (NHI) premiums.
The Legislative Yuan is expected to hold a vote soon to pass a third reading of amendments to the act, which would allow elderly people in the tax bracket below 20 percent to receive subsidies from the central government.
The proposed amendment would exacerbate generational inequality, and the increased financial strain could affect the future of the NHI scheme, five major medical associations said in a joint statement.
Photo: CNA
The five associations are the Taiwan Hospital Association, the Taiwan Medical Association, the Taiwan Union of Nurses Association, the Taiwan Nongovernmental Hospitals and Clinics Association and the Taiwan College of Healthcare Executive.
Between last year and the presidential election in January, presidential candidates and legislators from the Chinese Nationalist Party (KMT) and the Taiwan People’s Party have pushed the proposal.
However, the Ministry of Health and Welfare has maintained that it would cause a financial burden, leading to generational inequality.
Up to 70 percent of the NHI’s income is funded by people under 65, so exempting seniors from insurance premiums would burden the working population, they said, requesting that the proposal immediately be shelved.
The National Development Council estimates that Taiwan is to become a “super-aged” society next year, meaning that 20 percent of the population is to be 65 or older.
Medical costs for people older than 65 far exceed all other age groups. It is estimated that by 2070, the 15-to-64-year-old working-age population would decrease by 9.2 million, while people older than 65 would increase by 2.48 million, the associations said.
The NHI system was founded on the core principle of equitable risk-sharing, with all citizens contributing their fair share to receive healthcare. However, as elderly people require more medical attention and resources, the proposal would affect those contributing to the system. Insurance premiums should instead be calculated based on ability and fairness, they said.
If the central government were to provide NT$35 billion (US$1.07 billion) of subsidies, funds could be diverted from public services and welfare for other vulnerable groups including children, women and the disabled, impacting societal well-being, the associations said.
Young people graduating today might not earn as much as previous generations, so the proposed amendment would create generational injustices and infringe on the spirit of “equal burden, equal gain” of the health insurance system, Minister of Health and Welfare Chiu Tai-yuan (邱泰源) said at a meeting of the legislature’s Social Welfare and Environmental Hygiene Committee.
Moreover, next year’s NHI spending is to surpass NT$900 billion, an overall growth rate of between 3.5 and 5.5 percent, he added.
The proposal would also allow those older than 80 to apply for foreign caregivers without requiring a Barthel Index assessment, which measures a person’s ability to complete activities of daily living and mobility.
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