In a live webcast hosted by Executive Yuan Spokesperson Sun Lih-chyun on the Executive Yuan's "Open Mic" YouTube channel today, Sun and Minister Chiang Been-huang of the Ministry of Health and Welfare (MOHW) discussed Taiwan's long-term care system in light of its aging population.
While ROC nationals are enjoying a longer average life expectancy, the nation's birthrate is decreasing, Minister Chiang stated. As of 2015, people age 65 and over made up 12.2 percent of the total population, and this figure is expected to reach 14 percent by 2018, formally turning the nation into an aged society.
The aging of the population raises issues for long-term care; therefore, the government is implementing a three-phase long-term care policy. The first-phase has been a 10-year project to lay the groundwork for these services. The second phase is to enact legislation to establish a network for such care. The third phase is to promote a long-term care insurance system.
In May this year, the Legislature passed the Long-term Care Services Act. Meanwhile the long-term care insurance bill, which is aimed at generating funding for long-term care services, has been sent to the Legislature for review. All these measures will provide better care services for senior citizens with physical or mental impairments in an aged society.
As for improving carers' labor conditions, Chiang stated that in order to encourage homecare personnel to remain in their workplaces, the MOHW has raised their hourly wages, issued them certification licenses, and raised transportation subsidies for carers serving in remote areas. The MOHW will continue to strive for more financial resources so as to improve carers' salaries and labor conditions.
As for netizens' concern that the nation's demographic aging could result in long-term care becoming an unsustainable financial burden, Chiang stated that the long-term care system will be sustained by a long-term care fund of NT$12 billion (US$382.90 million) over five years. Other sources of funding include government budgetary allocations, tobacco surcharges and donations. In terms of expenditures on long-term care services, an estimated NT$100 billion (US$3.19 billion) is needed every year, which is just one-fifth of the expenditures of the National Health Insurance (NHI). This portion requires the funding of the insurance system and this is why it is necessary to implement a long-term care insurance system.
Some netizens asked about following the example of Japan by setting up long-term care departments in senior high and vocational schools to cultivate the work force. Chiang stated that Taiwan has been doing the same; however, there must be incentives for students to study in these fields. Moreover, the vocation's professional status, dignity, and career plan must be fostered. The MOHW has been working in these directions. Presently National Beidou Senior Home Economic & Commercial Vocational High School, Wuyu Senior High School, and Long Der Commercial and Household Vocational High School have related departments and courses. However, the work force produced is still insufficient. Nevertheless, sources of human resources are not confined to senior high and vocational schools; other departments in colleges and universities, like health and nursing, could also be included. The MOHW will continue to collaborate with the Ministry of Education to cultivate more long-term care personnel.
Some netizens questioned the relationships between the long-term care insurance system, labor insurance system and NHI system. Chiang stated that the three systems are each financially independent of each other. Since long-term care insurance is meant to take care of the disabled elderly, the objectives of the three systems are different and their finances do not depend on one another. Moreover, the labor insurance and NHI are financially healthy.
Some netizens also questioned the integrity of allowing profit-oriented businesses to operate long-term care services, which might result in the commercialization of these services. Chiang stated that the MOHW would like to see private-sector resources involved in the long-term care system and to develop long-term care into an "alluring" industry. However, the government will safeguard people's basic care. Individuals shall shoulder expenses for demands that go beyond basic care.
Some netizens stated that the Ministry of Labor (MOL) allows elderly 85 years of age and above with light disabilities to hire foreign carers, a policy that seems to run counter to the MOHW long-term care system. Chiang stated that the domestic work force takes priority in the nation's long-term care system and will be cultivated via education, but foreign carers with appropriate training can be hired to fill any shortages. Thus the MOHW and MOL policies do not contradict each other.
The live webcast began at 7:00 p.m. and ended at 8:00 p.m. The program can be viewed on the Executive Yuan's YouTube channel at https://goo.gl/n53MMD.