National Health Insurance Administration Director General Lee Po-chang said that while the decision to raise National Health Insurance (NHI) premiums to 5.17 percent is expected to temporarily ease the system’s financial strain, the NHI premium rate cannot be raised indefinitely in the long-term, further changes are required to ensure the system’s sustainability. As a result, proposals to adjust drug copayments and to charge copayments for diagnostic tests have been raised to prevent wastage of medical resources stemming from redundant drug prescriptions and diagnostic tests.

Director General Lee said that up to an estimated 70 percent of patients are not subject to copayments for drug prescriptions, which has prompted authorities to propose canceling copayment exemption for drug prescriptions of lower than NT$100, as well as charging a NT$40 copayment for drug prescriptions costing less than NT$300, with the cap on copayments to remain at NT$200. In response to concerns that higher copayments will be a burden for disadvantaged groups, Director General Lee said that copayments will only be raised by a limited amount at “around a few coins.”

Director General Lee noted that there are two separate plans to raise copayments for diagnostic tests, with the first calling for additional copayments of NT$50 to NT$200 depending on the level of the hospital where the tests were administered, regardless of the type of tests conducted. The other option is to charge additional copayments depending on the type of tests conducted, with tests costing lower than a certain amount to be subject to a base copayment.

Regarding copayments for drug prescriptions, Director General Lee emphasized that to ease burdens on the public, the additional copayments will be no more than 20 percent of the cost of drugs in accordance with the National Health Insurance Act. Regarding the proposal to cancel copayments for repeat prescriptions for chronic diseases, Director General Lee said that for chronically ill patients filling a refillable prescription for the first time will be charged a copayment at the same rate as regular prescriptions and that there will be no copayment caps on subsequent refills to achieve policy objectives of establishing a base copayment for drug prescriptions.

Department of Social Insurance Director Shang Tung-fu said that ongoing efforts to reform the NHI, including the reassessment of copayments on drug prescriptions and diagnostic tests, will be completed during the upcoming legislative session and likely be submitted for review in a National Health Insurance Committee (NHIC) meeting slated to take place towards the end of March. Provided that there is no major dissent among NHIC members, the proposed copayment increases will be submitted for approval by the Ministry of Health and Welfare and implemented in May at the soonest.

[2021-2-24/Apple Daily]