The issues raised by these proposals make it clear that both the public and government must face up to the limitations of free services.
Under the new freeway system, the tolls and free mileage will apply on north-south freeways, while east-west freeways will remain toll-free. Many drivers who now do not go through toll stations will have to pay, affecting mainly short- and middle-distance commuters.
With the first 20 kilometers free, the MOEA hopes to cut transportation costs for these commuters, maintain fairness for the average road user and reduce resistance to the toll policy.
Drivers who rarely use freeways, however, will not benefit from the free mileage, the provision of which means that the toll for each kilometer must be higher, so that the savings of short-distance travelers are paid for by occasional long-distance drivers. This structural unfairness is the reason many people have expressed opposition to the plan.
If free mileage is merely a stopgap measure to grease the wheels for distance-based tolls, the sunset clause should be spelled out clearly ahead of time to prevent further controversy. Moreover, the administration must let those who benefit understand that their free mileage will be paid for by other drivers.
Current competition between short-distance drivers and long-haul transport for space on the road has led to bottlenecks that defeat the whole purpose of a freeway. To keep traffic flowing, the free-mileage period should last at least a year, but no longer than three to four years. Drivers who do not wish to pay could use the time to scout out alternate routes on toll-free regional roadways.
The side effects of free services are equally obvious in the National Health Insurance plan. With 4 million holders of prescriptions for treatment of chronic illnesses filling their prescriptions entirely free of cost, many get more medicines than they need, resulting in serious financial losses and waste of medical resources. It makes no sense for those placing great demands on the health care system to pay nothing, while people who are only occasionally sick must help cover their costs.
It is time to revert to the original partial payment plan for chronically ill patients, which was changed 15 years ago as part of government efforts to promote separation of the prescription and dispensing of drugs. At that time, fees saved when clinics could not sell medicines were applied to subsidize them at independent pharmacies, leading over time to the widespread overfilling of prescriptions.
The real purpose of reinstituting partial payments is not to increase revenues, but to establish responsibility with a user-pays principle. This will stimulate patients to consume sensibly, and put a brake on their impulse to take whatever they can get free, whether they need it or not. Patients will pay just NT$100 (US$3.40) to NT$200 per month, but the benefits to the overall system will be huge.
Such modification of public behavior through an appropriate policy would be similar to Taipei City’s implementation of pay-by-bag garbage collection, which effectively led to more recycling and a great reduction in the amount of trash produced.
Fifteen years of free prescriptions for chronically ill patients has created waste in the health care system that must not be reduplicated on the nation’s freeways. People’s habits with regard to government services are not innate, but cultivated through irresponsible policies. (THN)
(This commentary originally appeared in the United Daily News March 31, 2013.)