The Ministry of Health and Welfare (MOHW) is expected to hold a meeting on Nov. 20 to discuss National Health Insurance (NHI) premiums. The Consumers’ Foundation said that in consideration of the widespread impacts of the COVID-19 pandemic, raising the NHI premium may unduly increase the burden on the public. The Foundation in a news conference called for a reexamination of the amount of NHI expenses that should be borne by the government as well as other measures including new taxes on alcohol and reassessing drug expenditure to ease the urgency of NHI premium increases.
Following consecutive years of deficits, the NHI is projected to reach NT$77.1 billion in the red before the end of 2021, with the system’s safety reserve set to dip below the legally required threshold equivalent to one month’s spending, which will trigger an increase of NHI premiums.
In light of the situation, the Consumer’s Foundation in a news release said that following the tremendous impacts of the COVID-19 pandemic throughout the first half first the year, the government should not rely on raising NHI premiums as the sole solution to address the NHI’s precarious financial condition. Rather, a full reexamination of the system is required to come up with solutions to the NHI’s structural issues.
Consumer’s Foundation Vice Chairman Wu Jong-da said that on average, annual NHI expenditures have been outpacing income by three percent, stemming from previous NHI premium cuts and a reduction of contributions from the tobacco excise tax to the NHI from 70 percent to 50 percent, as well as the raising of the threshold required to collect supplemental premiums from NT$5,000 to NT$20,000, which have all exacerbated the NHI’s ailing finances.
Vice Chairman Wu also mentioned that in the past, funding to treat AIDS were drawn from administrative budgets of government agencies instead of the NHI. However, the government has since amended laws that allow AIDS patients to have their treatment funded by the NHI’s program for chronic diseases following two years of treatment. In 2019, AIDS treatments led to an additional NT$4.1 billion in NHI expenditure, with spending projected to continue increasing each year.
In addition, the government has also expanded reimbursement for HCV treatments. Vice Chairman Wu said that in recent years, the change has led to an additional NT$22.681 billion in expenditure, becoming one of the factors leading to the NHI’s financial deterioration.
Vice Chairman Wu pointed out that apart from cutting expenditures, the National Health Insurance Act also has provisions for the government to levy an alcohol tax to expand NHI income, but the government has been reluctant to exercise the option. Chairman Wu also urged the government to consider precedents in other countries which are levying a sugar tax.
In addition, the National Health Insurance Act stipulates that the government’s annual total expenditure on the NHI shall not be less than 36% of total annual expenditure. Vice Chairman Wu said that the National Health Insurance Committee (NHIC) began discussions in several meetings in April 2018, and many times concluded that the government’s contribution did not conform to legal requirements. Upon closer inspection, the government has racked up a NT$48.7 billion shortfall in terms of its contribution to NHI funding. Vice Chairman Wu called on the government to make up the shortfall to ease the NHI’s financial pressure.
Vice Chairman Wu also noted that the 36 percent government contribution is only the minimum threshold, and that the government is allowed to shoulder a heavier burden to lessen the load on the public.
Vice Chairman Wu also pointed out that the National Health Insurance Administration’s proposal to raise NHI premiums from the current 4.69 percent to 5.52 percent or 5.55 percent is quite steep, and that increases should be limited to a range between 4.69 percent and 5.55 percent, which is equivalent to the premium rate prior to the implementation of premium cuts in the past to minimize impacts to the public and employers.
[2020-11-05/United Daily News]
