The Taiwan Young Patients Association calls for health insurance to re-examine the current premium calculation system that is centered on salary income, and establish a health insurance financial mechanism that is in line with changes in the population and income structure.
After the draft amendment to the "Elderly Welfare Act" was passed by Blue and White in a "surprise amendment", it caused a series of controversies. The Taiwan Young Patients Association emphasizes that Taiwan has entered a super-aged society, and the medical needs of the elderly population will continue to increase in the future, while the working-age population continues to decrease. The current premium calculation system, which is centered on salary income, should be re-examined and a health insurance financial mechanism should be established that is in line with changes in the population and income structure.
The Young Patients Association pointed out that according to the current premium calculation system of the National Health Insurance, which is based on "salary" income, the health insurance premiums paid by an office worker who earns 1 million through salary and a 65-year-old retiree who earns 1 million through passive income are completely different. The former brings about 72,456 yuan in premium income to the National Health Insurance throughout the year, while the latter only brings 37,624 yuan to the National Health Insurance. The difference between the two is nearly double.
The association believes that as Taiwan gradually enters a super-aged society, with a shrinking working population and an increasing number of retirees, allowing income from different sources to fairly share the financial responsibility of the national health insurance will become an important issue for the sustainability of health insurance and generational equity. We should not rely on the dividends of the technology and AI industries and regard them as "save financial resources" to meet long-term medical needs.
Therefore, the Young Patients Association also calls on the government to launch a social dialogue on health insurance financial reform, comprehensively review the calculation basis of health insurance premiums, implement the affordability principle, evaluate the effective premium burden derived from different sources, review the calculation methods, thresholds, upper limits and exemption regulations for general premiums and supplementary premiums, and take into account low-income family protection, double billing and administrative feasibility.
The association recommends that in addition to annual rates and revenue and expenditure forecasts, the population structure, income growth, medical needs and technological development should be taken into account, and a situational analysis of different financial resource combinations should be established to publicly explain the possible burdens of each generation and income group. True generational equity does not simply compare which age group uses more medical resources, but allows different generations to share the responsibility for medical security according to reasonable economic capabilities.
On the other hand, the association pointed out that health insurance financial reform involves the rights and interests of different generations, income groups and people with medical needs. The opinions of young people, patients, labor, medical professionals and other social groups should be included through open and transparent policy discussions to form a more legitimate and sustainable system consensus.
