From: jkh3@cunixa.cc.columbia.edu (Jerry K Huang)
Subject: Taiwan's Budget I
Keywords: Budget analysis, Inequitable distribution 
Organization: Columbia University
Date: Thu, 19 Nov 1992 09:07:56 GMT

Dear Colleagues:

Two weeks ago, I went to Washington DC to attend the 120th Annual Meeting
of the American Public Health Association, partly for fun and partly for
academic reasons. Among the hundreds of sessions in that huge meeting, I
attended one of the sessions that concern Taiwan area. 

The reason that Taiwan is able to be one of the hundreds of topics is that
Taiwan is apparently undergoing transition. The one I attended is named
'Emerging Medical Care Issues in a Changing Society: Taiwan Area'. Among
the four speakers in that session, one of them is Dr. Yueh-Guey Laura
Huang. She presented a work sponsored a subgroup, Ho-Seng Huei, in the
Legislative Yuan, to deal with the budget issue. (It's a funny thing
to chat with your international friends that a college professor, with
her husband in jail then, has to
service the political institutions, whatever he/she is 'mainstream' or not.
That sort of thing should have been done by a law-maker's aide in US. Or,
the State Department.) 

I later asked her whether she is going to have that presentation
published, and the answer was, for some reason, negative. But I feel
strongly that such information should be and has to be shared by people of
Taiwan as well as the academia altogether. I thus forward the following
stuff to you people without her consent and wish that she won't be upset
about it, which I guess she'd be happy though.

Jerry
*****************************************************************************


<Findings from an analysis of health and social budgets in Taiwan>

By: Yueh-Guey Laura Huang, DrPH, Institute of Hospital Administration,
    *********       *****        Chinese Medical College, Taichung, Taiwan 

[Abstract]

The study analyzed policy and allocation changes of central governmental
budgets in health, medical services, and social welfare. Data included
1989-1993 budgets in the central governement of Taiwan. Longitudinal
comparisons were conducted and the appropriateness of allocation and
categorization were examined. The results provided information for future
budeting, budget auditing, and policy implementation.

[Summary]

1. Total amount of budget for health care, environmental prottection, and
social welfare are relatively small.

2. The current budget data do not provide enough information to evaluate
the effectiveness of policy implementation.

3. The privilege and responsibility between local and central government
are not clear, therefore a significant proportion of funds are for
allocation. (meaning the allocation of the funds to private sectors or
commercial institutions to carry out project designing, policy and data
analysis, or piece-by-piece from central to local.)

4. A very large proportion of budget is for contract-out projects, no
evaluation or monitoring system exists to assess their outcomes.

5. The budget does not reflect some policy implementation plans.

6. The annual budget for oversea trips are regular without significant needs.

7. The budget for a single subject (eg. environmental protection) may be
listed under different departments, therefore an overall plan is difficult
to achieve. Duplicated, unequitable, or overlapped authorities are popular.
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There are ten tables and one chart in her report to the Annual Meeting. I
cannot type all of them onto the mainframe at this moment. However, if
this turns out to be an issue that arouses your interest of taking a look
at them, I'd be glad to enter one table a day for your curiosity's sake.

Nevertheless, I still would like to show you a table that lists the
"percentage of GDP for social expenditure in Taiwan compared to countries
of similar GDP" in the following. This is Table 11 in her report. 

Table 11.
-----------------------------------------------------------------------------
Countries   | Year | PerCapita GDP | Percentage of GDP for Social Expenditure
-----------------------------------------------------------------------------
Taiwan      | 93   | 9425          | 11.00
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Netherlands | 81   | 9861          | 36.14
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Belgium     | 80   | 10108         | 38.24
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Austria     | 81   | 9058          | 27.67
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Sweden      | 81   | 14772         | 33.26
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France      | 81   | 11688         | 29.36
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England     | 81   | 8965          | 23.54
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Canada      | 81   | 11944         | 21.03
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USA         | 81   | 12711         | 20.71
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Japan       | 81   | 9705          | 17.33
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Switzerland | 79   | 12900         | 20.02
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Australia   | 81   | 11393         | 18.88
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Sources: 1. Social Expenditure 1960-1990, OECD, 1985.

         2. Demographic Yearbook, United States, 1985.

PS: Please do not request me to send a copy of that report to you because
it was given as a handout, and I don't have "budget" to pay for the
transmission, whether fax or snail mail.