Paper of Aurelio Estrada
Taiwan Coordinator - Asia Pacific Mission for Migrant Workers (APMM)
October 15, 2005, Taipei, Taiwan

On behalf of the Asia Pacific Mission for Migrants I bring you all warm greetings of solidarity!

I would also like to thank the organizers of this activity, the Taishe Journal and AHRLIM for inviting me to share with you our analysis on the issue we are discussing tonight.

The recent decision by the CLA liberalizes the hiring of foreign caretakers in Taiwan by doing away with the so-called "Barthel" index determined by physicians in determining whether employers can hire migrants. Instead, it is now up to the Department of Health who will determine whether applications for hiring foreign caretakers would be necessary.

This decision reinforces the relegation of this essential social service from the Taiwan government to the private sector. This is consistent with the Taiwan government’s commitment to the General Agreement on Trade in Services (GATS), which is one of the agreements administered by the WTO.

At the same time, this decision would only satisfy Taiwanese brokers, recruitment agencies and governments of labor exporting countries that would benefit financially from the sweat and blood of foreign caretakers. The CLA is also silent on the human and labor rights of these caretakers given that the Taiwanese government has recently created a human rights committee for foreign workers. The decision also worries local caretakers who might be eased out from this market given that migrants are paid only between ½ and 1/3 compared to them.

The GATS liberalizes services by dismantling traditional restrictions by governments on various services sectors. This includes health care; hospital care; dental care; childcare; and elderly care among others. Of course, what is more popular in Taiwan is the privatization of the telecommunications giant, Chunghua Telecom. But that is another story.

Taiwan prides itself with its National Health Insurance (NHI). The NHI itself is chronically ill. After only three years of existence, the NHI’s expenditures exceeded its revenues in 1998. According to a study, the revenues of NHI increased at an average of 4.26 percent per year, while its expenses increased at 6.26 percent from 1995-2001. Only the huge cash reserves accumulated from its first three years of existence was it able to pay for its deficits from 1998-2002. But by mid-2002, its cash reserve decreased to only less than a month of its expenditures that the Bureau of National Health Insurance (BNHI) was forced to lend from banks at NT$50 billion a month to be able to pay its claims. Given that Taiwan’s elderly population will increase in the immediate future, the problem of health-care financing will always be there.

That is why the NHI can only pay for chronically ill patients but cannot afford to do so for nursing homes. That is also the reason why so many hospitals are flooded with elderly persons suffering from chronic illnesses. Nursing homes are also required by the government to provide high standards of equipment and staff making it financially difficult for many Taiwanese to avail of its services. Many nursing homes are affiliated with hospitals. Considering that most hospitals or around 84.5% are privately owned, they do tend to be expensive.

So the best way to solve the problem of accessing service to caregivers is to make it easier for families to hire cheaper and more flexible foreign workers. As of Dec. 2004, there were already 128,223 alien nursing workers from six nationalities. These include an unknown number working in nursing homes and in hospitals that are hired by such institutions.

The Labor Standards Law has covered this category of workers since two years ago. But its implementation is hardly followed especially in terms for payment for overtime pay. Many of these migrants also work in night shift and tend to take care of more than five persons, which is another violation of Taiwanese laws.

Of course those working at homes are more numerous and are more valued by their employers than local ones. This is not only because they are cheaper to hire, but can be made to work for longer periods including their days off and can be assigned other tasks like cleaning the house and cooking for the household.

Brokers in Taiwan and recruitment agencies in the sending countries would also benefit greatly from this caretaker industry. Their coffers are taken cared off by the fees they impose both legal and done under the table on the foreign workers. What is disgusting is the recent revelation made by the CLA last September 6 that what the migrants actually pay for to the brokers is not a service fee but in actuality is a management fee.

So in effect it is the migrant worker who subsidizes his/her employer for the latter to have somebody help them manage their foreign workers. This is also a great insult to employers of caretakers as they themselves can do this by themselves. The only excuse that the CLA can think of about this fee is that foreign workers are hard to manage. I do not want to guess if this remark is racist or not. But this is obviously a matter of legal extortion through forced collection of management fees.

Both the governments of the exporting countries and Taiwan can also greatly benefit from this latest CLA proposal on foreign caretakers. Those from the former would earn more foreign reserves remitted by their nationalities and from the fees they impose to prop up their bankrupt economies.

The Taiwan government would also benefit from this by not taking the responsibility of providing essential social services to its people but by passing it back to them. It would save a lot financially from this arrangement considering that it has had yearly budget deficits since the start of this century and has acquired a considerable large amount of loans. Its budget for its Department of Health is only a pitiful 2.6 percent.

We have also heard from our Taiwanese friends that even the salaries of locals in nursing homes are going down. While the minimum wage, which is the usual pay for foreign workers has not been raised since 1998. This is one feature of liberal globalization whereby wages are frozen or even are decreased.

One other benefit that the Taiwan government would get from this is that it might bank on its local people to eye the foreign caretakers as their main target. This has already been reported in the newspapers that the locals perceive the migrants as taking away their jobs. If this would not work it can also pit the employers of foreign caretakers to criticize locals who do not approve of this new policy.

We must not fall into this trap. Essential services including that of providing nursing needs of people is the main responsibility of governments. I do not have figures on how many nursing homes are privately and publicly owned. But clearly most hospitals and especially clinics are of the former category.

More local workers can even be hired if the government can put more public money into nursing homes and hospitals. At the same time those working in homes both migrant and local should be under the Labor Standards Law like their counterparts in care giving institutions.

Migrants and locals should thus unite in defending their rights, welfare, jobs, wages and services.

Stop the privatization of the health care program!

Secure the jobs of local workers!

Protect the rights and welfare of migrant workers!

Migrant and local working people unite against neo-liberal globalization!