The Extend Thinking about Super-aged Society
Pei-Chun Hsu
（Yuan Ze University social work credit courses）

The long-term care budget for the year 2024 has exceeded 80 billion, representing the highest rate of increase over the years. Since the enactment of the Long Term Care Act in 2016, the budget has consistently increased annually. However, last year marked the first time that long-term care expenditures incurred a deficit. With tax income instability and the annual increase in the disabled population, there are numerous hidden concerns in the future blueprint of long-term care services beyond budgetary increases. Therefore, we need to take a comprehensive approach and formulate policies effectively rather than dealing with matters superficially.

The long-term care fund relies on various sources of Opportunity Tax income, such as House and Land Transactions Income Tax, Gift Tax, Inheritance Tax, Tobacco and Alcohol Tax, among others. However, real estate market transactions have peaked, leading to a decrease in tax income. This resulted in a deficit in long-term care expenditures last year. The government needs to expedite the organization of town hall meetings to establish policies that can stabilize the long-term care fund, whether through increasing taxes or promoting long-term care insurance plans.

Additionally, we need to prioritize the health literacy of long-term care services. Taiwan is poised to become a super-aged society by next year, meaning one in five citizens will be a senior citizen. Hence, it’s imperative to reconsider the definition of elder at age 65 due to differences in time and space backgrounds. With advancements in medical care and nutrition, life expectancy has increased, warranting a negotiation on defining elder at age 65 and retirement age. The labor force is likely to face challenges due to the baby boomer dilemma. Thus, the government should take proactive steps beyond promoting and encouraging the re-employment of elderly individuals.

Furthermore, are we adequately equipped with the quality and specialization of home caregiver services to meet the increasing needs of the elderly? Do we possess sufficient education in gerontology, encompassing knowledge of geriatric care, medicine, and diseases? Do we have the requisite knowledge and skills for new caregivers, nighttime caregivers, or terminal caregivers? Are resident care attendants improving and being evaluated for their professional skills and literacy annually? Is the government providing appropriate guidance to Adult Day Care Centers emerging in the markets and effectively managing them? Is there a solution to maintain care service quality during shortages? These are pressing issues that require immediate attention.

The Ministry of Health and Welfare acknowledges that although long-term care expenditures incurred a deficit in the year 2023, the tax revenue from past years can sustain it for at least 5 years. In other words, the dilemma faced by long-term care has only a 5-year buffer period to be addressed. The government must take practical actions to solve the problem and implement policies from a longer-term perspective.