Many cancer patients have said that that the National Health Insurance (NHI) system has not addressed the concerns of those who are willing to shoulder higher National Health Insurance premiums as well as copayments. On Dec. 31, 2020 Minister of Welfare Chen Shih-chung decided to raise NHI premiums from 4.69 percent to 5.17 percent, making employees earning monthly salaries of NT$30,000 subject to an additional NT$40 in monthly NHI premiums.

Despite the importance of expanding NHI income, cost cutting measures such as the National Health Insurance Administrations (NHIA) proposals to raise the cap on drug copayments and requiring copayments for diagnostic tests, are equally important, and the they garnered support among 61.3 percent and 58.7 percent of respondents respectively in a recent poll by the Hope Foundation for Cancer Care, with 77.2 percent willing to shoulder higher fees for treating minor illnesses as to preserve NHI resources for critical diseases.

Still, many experts still remain concerned about potential harms to disadvantaged groups from the changes to copayment policy. Therefore, contingency measures must be taken to ensure that the interests of disadvantaged groups are not neglected as the NHI expands its income streams.

Since its establishment 25 years ago, the NHI has continued to garner renown and high satisfaction rates. However, Hope Foundation for Cancer Care have observed that the amount of resources allocated to patients with cancer and other critical illnesses have continued to decrease in recent years.

Pressured by ailing finances, the amount of innovative drugs added to NHI reimbursement have fallen below global norms and have been inadequate in meeting clinical needs. Patients often resort to emptying their savings or even going into debt to receive treatment for the chance of overcoming their disease. It is hoped that the NHI can do more for cancer patients.

The Hope Foundation for Cancer Care is not urging for all new drugs and innovative treatments to be included under NHI reimbursement. Rather, it is hoped that more budget and manpower can be allocated towards health technology assessment to identify new treatment options that have been stringently proven to be effective can be included under NHI reimbursement and made accessible to patients. The same assessment may also be applied to exclude ineffective drugs from NHI reimbursement to maximize the value of NHI resources.

The Hope Foundation for Cancer Care is aiming for objective and practical solutions to address NHI finances and supports the NHIA’s proposed measures, including canceling copayment exemption for patients with catastrophic illnesses, returning to the original terms of the copayment system as well as setting up assurances to protect the interests of the disadvantaged. We hope that the government the fortitude to carryout reforms to build a fairer and more equitable. The NHI should also return to its original spirit as a form of social insurance where care is provided to disadvantaged patients and those with catastrophic illnesses. That way, the quality of health care provision can be elevated while people are prevented from falling into poverty from illnesses.