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Close up of doctor and patient sitting at the desk near the window in hospital (Photo by Andrei_R from Shutterstock).

Comparison of public healthcare financing between Taiwan and Singapore

by Roy Yi Ling Ngerng

In an article Channel NewsAsia wrote yesterday, it talked about a Ms Serynn Guay who said that “one of her worries is “unpredictable” healthcare bills”.

She said: “We don’t know how much we’ll need when we’re older … Will we be able to retire comfortably? Will our savings be enough?”

She added: “It’s likely that we’ll continue working for at least the next two decades. Even after my child completes university, we still need to continue saving for retirement and other living expenses.”

I just want to let you know what it is like in Taiwan.

In Taiwan, healthcare is free and for someone who starts work today and works for 40 years, he/she would be able to retire with at least 60% of his/her salary, under the current national health and retirement schemes.

As such, the worries that Singaporeans have are not felt in Taiwan. People know they can see a doctor when they are unwell and receive quality healthcare. They do not need to be scared, or choose not to see a doctor because they cannot afford it.

People also know that when they reach retirement age, they can retire and many of them do actually look forward to retirement, because they can actually retire.

In Singapore, Singaporeans pay tax and also into Medisave and MediShield, and they pay a hell lot of money into these, but they still have to be scared about seeing a doctor, and many therefore choose not to do so.

To give you the context, in Taiwan, employees only pay about 1% plus of their wages into health insurance, and they get free healthcare. In Singapore, we pay 8% to 10.5% of our wages into Medisave but we still cannot get free healthcare. Instead, we still have to pay for one of the most expensive out-of-pocket expenditure for healthcare.

In Singapore, we pay 37% of our wages into the CPF retirement fund, but we still cannot be guaranteed a fixed minimum amount of retirement funds. In 2011, the median CPF payout was only S$260 and in 2014, the median CPF payout was only S$394. Compared to median wage, the payouts are only 10% of median wage.

In Taiwan, the Taiwanese pay a small amount of their wages into the national schemes to receive free healthcare and guaranteed retirement.

In Singapore, Singaporeans pay one of the highest contributions in the world into Medisave and and the highest contribution into CPF, but still have to pay for one of the most expensive out-of-pocket healthcare and cannot even be guaranteed retirement, and in fact, earn one of the least adequate retirement funds around.

Sure, the Taiwanese earn lower wages but what this means is they cannot travel as much as they would want to.

In Singapore, we think that Singaporeans earn higher salaries but do you know that there are still Singaporeans who earn lesser than the minimum wage in Taiwan, and for the bottom 30% to 50%, they might not even be able to save as much as the Taiwanese and might be worse off. Singapore’s wages are only truly “high” among the top 20% to 30%.

What low-income earners in Singapore earn is lower than the minimum wages in all the Western European and Anglo-Saxon countries and in Japan and South Korea, where the cost of living is similar. Singapore’s median wage is also lower than almost all the Western European and Anglo-Saxon countries. And so, many Singaporeans have to live like Ms Serynn Guay quoted in Channel NewsAsia’s article, who have to worry incessantly about basic social protection.

In Taiwan, I earn lower wages so what I miss is being able to travel to further away places for holidays. But what I gain is the peace of mind that when I fall sick, I can see a doctor or go to the hospital anytime because even I, a foreigner, is covered under the National Health Insurance scheme, and am able to obtain free healthcare. And if I am Taiwanese, I would be able to know for sure that I can retire.

Needless to say, if you are in one of the Western European countries, or in countries like Canada, Australia and New Zealand, not only are wages high, but the social protection citizens are able to enjoy means that in their societies, they are able to truly have a good quality of life.

Reason why Singaporeans can’t? You don’t push back against the PAP. Many Taiwanese ask me: why do Singaporeans take this sitting down, all the crap that the PAP is doing to them?

I say: because they don’t dare to protest. Because we are scared.

And so, we continue fearing for our lives, when we could have the world.

Happy Lunar New Year!

This was first published on Roy Yi Ling Ngerng’s Facebook page and reproduced with permission.