Taiwan's proposed amendment to the Senior Citizens Welfare Act to exempt people aged 65 and above from paying National Health Insurance (NHI) premiums could create financial distress for the NHI programme. The programme is already running under severe financial strain.
Two political parties in Taiwan are advocating the proposed amendment. The government has, however, said that promoting such a policy would only worsen the financial crisis of NHI and ultimately harm all Taiwanese.
The majority of the revenue for NHI comes from the contribution of young adults but the majority of its expenditures go to take care of elderly people. As the elderly population increases, the burden on young adults and thus on the NHI grows heavier.
In 2023 NHI data showed that the NHI’s revenue growth is limited, while its expenditures are rapidly increasing — the key factor being that the ageing population has caused medical requirements and thus the expenses to surge. A senior medical professional said exempting people over the age of 65 from paying NHI premiums is tantamount to digging a bigger hole for a financial pool that is already drained.
According to official data exempting people over the age of 65 would cost an extra NT$35bn ($1.07bn). That sum would have to be diverted from the resources of other public programmes. According to media reports NHI is now more than three decades old and is facing multiple challenges, including a rapidly ageing society, a rise in the number of chronic illnesses, a shrinking working population due to a low birthrate and uneven distribution of medical resources.
Some of the senior citizens in Taiwan do require economic support, however, many of them also are financially comfortable and can afford to pay the NHI premium. According to health professionals, it would not be correct to treat all seniors equally and exempt them from paying premiums, this would put the economically disadvantaged elderly to further distress.