On the question of how to reform the National Health Insurance (NHI) and to improve access to the latest treatment options, Hope Foundation for Cancer Care Chairman Wang Cheng-hsu, who also serves as an attending physician at the Division of Hematology and Oncology at the Keelung Chang Gung Memorial Hospital, recommended the government to steer the NHI in returning to the spirit of the system’s original design. Chairman Wang said that copayments should capped by a fixed rate instead of a fixed amount in conjunction with an annual cap for each patient. Patients should also purchase commercial health insurance to help cover potential treatment costs to allow Taiwan to have quicker access to new drugs.

Chairman Wang said that originally, the NHI had a fixed, 20 percent copayment rate, meaning that a patient would be required to pay NT$40,000 out of a NT$200,000 bill for inpatient care. To lower patients’ financial burden, copayments should still be capped by a yearly limit and a cap on each medical consultation.

Patient groups have been voicing differing opinions on copayments for new drugs, with some hoping for higher fixed amount copayments across the board, while others have called for a dual track system where higher fixed amount copayments are charged for patients with common illnesses, while patients requiring expensive oncology drugs are charged fixed rate copayment. However, Chairman Wang said that the copayment rules should not distinguish between patients with different diseases and that the terms should be congruent to ensure fairness.

More and more consumers are becoming aware of the user-pays principle and that they should shoulder some of the responsibility of ensuring the sustainability of the NHI. Instead of purchasing whole life savings insurance products where a lump sum payout is provided upon maturity, consumers should purchase complementary commercial health and accident insurance products to round out their protection and refrain from expectations that the NHI will cover the entirety of their medical expenses.

Chairman Wang suggested that the government provide guidance to the insurance industry to encourage consumers to purchase a mix of commercial life, accident and health insurance products to ensure protection as well as access to new drugs.

[2010-10-30/United Daily News]