The Formosa Republican Association on Oct. 3 organized a forum, where Minister of Health and Welfare Chen Shih-chung reiterated his resolve to raise National Health Insurance (NHI) premiums. However, five medical organizations, including a preparatory committee of an upcoming national labor union for physicians and health care workers, responded by saying that a complete overhaul of the NHI, including a reevaluation of the composition of the National Health Insurance Committee (NHIC), is required. The organizations also said that Taiwan’s health care environment must be improved to provide better working conditions for health professionals and that a separate insurance system must be established for long-term care and total care, calling on the government to stand together with health care workers in protecting the NHI.
Data from the Ministry of Health and Welfare show that the NHI has continued to record financial shortfalls in the past few years and that before the end of 2021, the system’s safety reserve will likely dip to 0.54 month’s of NHI expenditure, falling short of the legally required threshold equivalent to one month’s expenditure. Regarding the NHI’s mounting financial shortfall, which has swelled to NT$77.1 billion, Minister Chen said that NHI premiums must be raised. “Good health requires investments,” Minister Chen said at the event.
In response to Minister Chen’s remarks, the preparatory committee, the R.O.C. Primary Care Association, the Chiayi Christian Hospital Labor Union, the Taipei Doctors Union and the Taiwan Medical Alliance for Labor Justice and Patient Safety urged that a complete overhaul of the NHI is needed and issued a joint statement.
The preparatory committee said that in the absence of changes to the system, raising NHI premiums will do little to address the system’s mounting losses. If the government is sincere in expanding investments into the health care industry, it should strive towards a more flexible health care environment that is able to foster the development of advanced medical sciences and help boost economic activities. The government’s single-mindedness in restricting the use of medical devices and the diagnostic decisions of medical professionals, while helpful in containing costs, will be of little help to the industry’s development.
The joint statement also said that to in order to invest in health, investments must also be made to the health care environment, which encompasses not only hardware but also the cultivation of medical talent, which is what drives Taiwan’s world-leading soft power. Medical professionals must be treated fairly and protected from frivolous lawsuits, poor working conditions and threats of violence in order to maximize the capabilities of the NHI system.
The statement also emphasized that the NHIC, which is tasked with reviewing the NT$700 billion NHI system, the scale of which is roughly equal to half of Taiwan’s annual government budget, includes payers’ representatives whose appointments have not been backed by organizations representing the will of the people and do not go through the rigorous process of preventing conflicts of interests and asset disclosures. While there are rules that NHIC members are barred from serving more than two terms, the same individuals often linger on their posts as proxies.
The five medical organizations in a joint statement urged the government to:
- Reevaluate the composition of the NHIC and to increase representation of physicians and to reassess the appointment process to ensure that the medical community and the government are aligned in efforts to ensure protection of the public’s health, as well as to ensure the sustainable development of Taiwan’s health care systems.
- Improve Taiwan’s health care environment, reevaluate the distribution of resources and reimbursements across medical institutions of all scales, address long-running issues in Taiwan’s health care provider evaluation system to ensure Taiwan’s medical talent pool and provision of health care in rural areas.
- Providing funding for long-term care and total care independent from the NHI in order to ensure sustainability.
[2020-10-7 / Healthnews]