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Published: July 27, 2006
The Social Security Panel of the Conference on Sustaining Taiwan's Economic Development was convened on the morning of July 27, 2006 to deliberate key issues in connection with efforts to enhance the social security system. The discussion was co-chaired by Premier Su Tseng-chang, Vice President of the Legislative Yuan Chung Jung-chi, and Minister without Portfolio Lin Wan-i. About 150 representatives from the Legislative Yuan, government agencies, academia, business, social organizations and labor groups took part in the conference.
Among the issues discussed were: the impacts of an aging population coupled with a declining birth rate and approaches to meeting the challenges posed by them; establishment of a national pension program; reform of the National Health Insurance (NHI) system; and narrowing the income gap. The participants reached the following major consensuses:
(1) In response to an aging population, the government should expedite the establishment of a stable and viable fiscal and budgetary system to support the development of policies for extended caregiving for the elderly that is diversified, community-based, high-quality, and comprehensive, taking into account differences in conditions between genders, urban and rural areas, cultures, professions, economic status and health conditions. In addition, extended caregiving programs should be provided in the spirit of nonprofit service, and the government should make effective policies to coordinate resources in the private sector.
(2) In response to a declining birth rate, the government should develop an environment that is conducive to child bearing, raising children and providing quality education. Furthermore, a mechanism for providing support for parents, both working and nonworking, when they take unpaid parental leave and for childcare should be established. Salaries of women on maternity leave should be paid via the labor insurance program in order to encourage people to marry and bear children, thereby helping to stabilize population size and age structure.
(3) The goal of building a fair national pension system is to rectify economic security problems associated with citizens who do not participate in any social security system that provides a pension. This is also aimed at ensuring fairness and providing appropriate protection of elder citizens' economic security. Measures should be taken to ensure that such a pension system has a stable financial structure and reasonable premiums, and should be based on a realistic estimate of how large a financial burden the nation can bear. The government should aim to complete relevant legislation by 2007.
(4) As for the NHI system, although it has developed a fairly sound foundation, in a superior public health care system, premiums should also be set in accordance with the principles of ability-to-pay and risk sharing; responsibility for premium payments should be shared by the insured, employers, and the government in a reasonable and fair manner; and the amount of premiums paid by the insured should be based on total household income.
Consideration must also be given, with regard to NHI revenues and expenditures, to reasonable increases in medical expenditures, while efforts must be made to prevent the growth of inappropriate costs such as those incurred by waste of health care services and manipulation of differences in costs of drugs. The insurance costs thus calculated should then serve as the basis for NHI revenues and expenditures.
Moreover, in order to establish a mechanism that can scientifically supervise and manage medical costs as part of a forward-looking reform program, the NHI system for reimbursing health care institutions should shift from its fee-for-service standard to pay-for-performance and fee-per-case standards.
(5) To reduce income disparities, the government must begin by addressing issues related to education, employment, social security and taxation. Substantive measures include: developing industries that embody local characteristics; creating new job opportunities in economically depressed areas; increasing educational opportunities of children in disadvantaged families and upgrading the quality of their education; and ensuring reasonable employment opportunities and good labor conditions for the disadvantaged.
In addition, the government should integrate social welfare resources, consider raising the ratio of profits from "public interest lotteries" currently allocated for social welfare programs, and build an effective mechanism to assist the disadvantaged.
Other measures aimed at promoting social justice include implementing a taxation system based on ability to pay, so as to achieve a better balance of income distribution, and reassessing the current pension systems for military personnel, civil servants and teachers. It is expected that these measures will make significant contributions to advancing social justice, as well as to effective allocation and sustainable development of national resources.
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