蕭錫惠 | Hsiao Hsi-huei
長照為何成了敗票工程
——從善意政策到民怨累積
長照政策，本是民進黨最重要的社會福利政見之一。初衷是善意的：照顧高齡人口、減輕家庭壓力、讓社會更有溫度。然而，實際上路多年，民間反應卻不如預期，甚至在基層引發反感。最直接的例子，就是許多居家服務員——原本應該是政策受益者與推動者——卻在選舉中公開表達「拒投民進黨」。這樣的落差，不僅令人警惕，更凸顯政策與人民感受之間存在巨大斷層。
問題出在哪裡？首先，居服員待遇偏低，長時間勞動卻收入有限，社會地位也不受尊重。政府不斷喊口號「長照是社會責任」，但實際給予的保障不足，讓第一線的照顧者覺得被利用。其次，家庭的使用體驗並不好。許多人反映申請手續繁瑣、等待時間過長，資源不足甚至導致「紙上有政策，家裡沒服務」。久而久之，長照成了「理想很美好、現實卻無感」的政策。
這也是民進黨近三次選舉選票不斷流失的重要原因之一。2018 年地方選舉大敗，本是第一次警鐘；2022 年疫情後選舉，再次慘敗；2024 年賴清德雖然當選，但得票率下滑到 40%，立法院更陷少數局面，已經顯示民意支持盤逐漸鬆動。這些警訊不能怪罪選民「不懂政策」，而是執政者忽視了人民的真實感受。政策不是寫在白皮書或簡報上，而是人民每天生活的具體體驗。
執政者常常掉入「左膠陷阱」：沉醉於數據、制度與理想，卻缺乏人性化思維。對人民來說，長照不是一個美麗的口號，而是「我家老人需要馬上得到幫助」「我付得起費用」「我敢信任照顧品質」。當這些需求沒有被滿足，再漂亮的政策設計都只會成為空中樓閣。
因此，民進黨必須深刻反省，並提出具體改善方案：
第一，改善居服員薪資制度，將照服工作納入準公共化保障，至少比照勞動市場平均薪資，並提供進修與升遷管道。
第二，簡化申請流程，導入單一窗口與數位化系統，讓家庭能快速取得服務，而不是被公文折磨。
第三，提升品質監督，確保服務標準一致，避免地方差距，並建立申訴與即時協助機制。
第四，推動社區共照模式，結合地方診所、社區中心與志工，讓照顧更貼近生活，而非遙不可及的制度設計。
政治的核心，不只是治理，而是「與人民共感」。2018、2022、2024 的教訓已經非常清楚，若再繼續漠視，長照將不只是政策的困境，而會成為民進黨執政的滑鐵盧。
本文原登於自由時報《自由廣場》2025-09-04
Failures in long-term care hurt the DPP
The Long-term Care Plan was originally one of the most important aspects of the Democratic Progressive Party’s (DPP) social welfare agenda. Its original intention was well-meaning — to provide care for the elderly population, reduce the burden on families and make society as a whole more compassionate.
However, after having been implemented for several years, the public response to the plan did not meet expectations — it has caused resentment even on the front lines. The most direct example of this is that home care workers, who were supposed to be the policy’s greatest beneficiaries and promoters, have publicly expressed an unwillingness to support the DPP during elections. This alarming gap highlights a major disconnect between the policy and public opinion. So what exactly is the problem?
Home care workers earn low wages, despite their long working hours, and generally lack respect in society. While the government keeps touting long-term care as a social responsibility, the actual assurances provided for those in the field are insufficient, and frontline caregivers feel that they have been exploited as a result.
On top of this, families that employ home care services typically have negative experiences. Many complain about overly cumbersome application procedures, long waiting times and a lack of resources, leaving families with no real care services. Over time, the long-term care policy has become one that sounds ideal on the surface, but is entirely disconnected from reality.
This is one of the main reasons why the DPP has continued to see a decline in votes in the past three elections. The DPP suffered a devastating loss in the 2018 local elections, where the Chinese Nationalist Party (KMT) won a majority of city, county and municipal governments. The party suffered yet another blow during the 2022 local elections. Although President William Lai (賴清德) won last year’s presidential election, his vote share dropped to just 40.05 percent and the DPP became the minority in the Legislative Yuan.
These warning signs cannot be blamed on voters “not understanding policy,” but rather on the ruling party for turning a blind eye to the true feelings of citizens. Policy is more than just briefs and reports — it requires a humane approach that focuses on the concrete experiences of peoples’ daily lives.
For the public, long-term care is not some flowery slogan, but a real need: “My elderly family member needs immediate help,” “I can afford the costs,” and “I trust that they will receive quality care.” Regardless of how well-designed a policy is, if the public’s needs are not met, it is nothing but an empty promise.
Thus, the DPP should devise a plan for concrete improvement. First, it should improve the salary system for home care workers by incorporating caregiving into a semi-public protection framework to ensure that wages at least match the average labor market salary. It should also expand opportunities for further education and promotion in the caregiving field.
Next, it should simplify the application process for families seeking care by introducing a single-window and digital system, allowing families to access care services quickly instead of being overwhelmed by paperwork.
Third, it should implement measures to improve quality control of care services to ensure consistency with service standards and avoid regional disparities, and further establish complaint and real-time assistance mechanisms.
Finally, it should promote a community care model that encourages cooperation between local clinics, community centers and volunteers, so that care is more closely connected with daily life.
At its core, politics is about more than just governance — it is about possessing empathy for citizens. If long-term care becomes a more severe policy dilemma, it could lead to another major defeat for the DPP government.