◎ Golden Shun
The Legislative Yuan passed the draft amendment to the "Elderly Welfare Law" on the third reading on October 16. Elderly people over 65 years old whose income tax rate does not reach 20% will have their health insurance premiums fully subsidized by the central government. On the surface, it is about respecting the elderly, but in reality, it is a political check that does not fully account for stable financial resources and has the next generation to foot the bill.
The Legislative Yuan passed the amendment to Article 22 of the Elderly Welfare Law on the third reading on October 16. Elders whose comprehensive income in the past year has not reached the reporting standard or whose comprehensive income tax rate has not reached 20% will have full health insurance premiums subsidized by the central competent authority. (Central News Agency file photo)
I am 67 years old and an elderly person. I have also been involved in the planning, advocacy and implementation of pharmaceutical and health care policies for a long time. I support the government in taking care of the vulnerable elderly, but I do not agree with age alone being the criterion. The threshold for the "wealth exclusion" clause in this revised law is that the income tax rate does not reach 20%. At the 115-year progressive tax rate, the comprehensive net income must be greater than 1,380,001 yuan (1.38 million yuan). Currently, about 4.03 million of the 4.85 million elderly people are eligible, with a rate as high as 83%. This clause is almost in vain. This will allow retirees with multiple properties, savings and dividend income to receive subsidies because their taxable income does not reach the threshold; while salaried people who are raising children and paying mortgages will have to bear the burden through taxes or increased premiums. According to estimates by the Ministry of Health and Welfare, if it is financed by insurance premiums, the average working population aged 20 to 64 will increase by approximately 2,690 yuan per person per year; if it is financed by taxes, each taxpaying family will increase by approximately 5,720 yuan per year.
This policy requires approximately 40 billion yuan in the first year. As the elderly population increases, expenditures will continue to rise. In the future, taxes may be increased, health insurance premiums may be raised, and important policies such as long-term care, child welfare, new cancer drugs, and rural medical care may be squeezed out due to budgetary subsidies. Just telling the elders "you don't have to pay" but not daring to clarify "who will pay" is irresponsible governance.
If we want to expand health insurance subsidies, we should use household income and assets as the standard, include real estate, dividends, interest and retirement income, and provide a complete financial resources and long-term financial impact report. In addition, this amendment deletes the subsidy provisions for the elderly's partial burden and medical expenses not covered by health insurance, and only fully subsidizes the "health premium" part. This may cause those with real medical needs to lose other substantive subsidies other than health insurance.
If we want to expand health insurance subsidies, we should use household income and assets as the standard, include real estate, dividends, interest and retirement income, and provide a complete financial resources and long-term financial impact report. (File photo)
To put it bluntly, if we want to provide subsidies for the elderly, the average life expectancy of Chinese people in 2014 has reached 81.27 years. Domestic studies have pointed out that the division of the elderly population and related policies should be based on the average remaining life span. For example, I am still healthy at 67 years old. If we really want to expand subsidies for the elderly, the age may be 75 years old. We should plan financial resources as mentioned above and use household income and assets as the basis for wealth ranking.
Health insurance is a social insurance rather than an election gift. Its core spirit should be affordability, risk diversification and mutual assistance from generation to generation. The weak should be provided with appropriate assistance, and those who are capable should work together to protect it, in order to achieve sustainability. Respecting the elderly is not free for everyone. Welfare that lacks financial resources and lacks substantial benefits for the rich is not a virtuous policy. It turns today's applause into tomorrow's bills for the next generation.
(The author is the chairman of the Taiwan General Health Medical Alliance Association and the honorary chairman of the National Federation of Pharmacists Association)
