There will be a radical reform of the NHI payment system, according to Dr Chen Shih-Chung, the MOHW Minister.  The reform plan includes two significant changes.   Firstly, institutes providing long-term care will also be able to receive NHI reimbursement.     Secondly, the NHI services will be extended to public health and preventive medicine.  Dr Chen stressed that the NHI payment regulation is a tool, and it should be formulated and used wisely to enhance the nation’s health.   

Currently, the reimbursement for hospice care is subject to strict regulations.  The NHI-reimbursed services are only available to patients admitted into hospitals.  Those who are staying in care institutes are not eligible for the NHI reimbursement.  In the future, the regulation has to be patient-centered.  This will help to reduce the NHI expenses.  Under current regulations, patients have to be transferred to hospitals to receive NHI-reimbursed care and this may cause the waste of resource.

If patients are able to access NHI-reimbursed care in care institutes, it will help to free up hospital beds and to reduce cost.

Teng Xi-Hua, the spokesperson of the NHI Supervision Alliance, a consumer watchdog, welcomes this proposal.  Residents in care homes usually have to be hurried to hospitals once their conditions deteriorate.   It would be more humane if they are able to receive the same hospice care where they are. 

Also, medical services should be delivered in care homes to save the residents from travelling.  Teng Xi-Hua pointed out that the NHIA should extend the scope of medical services that can be performed in care homes and increase the payments to doctors as an incentive.

To support the preventive medicine is another key point of the reform plan.  For example, if doctors focus on treating the underlying cause of a condition instead of tackling the symptoms, it will reduce the total treatment expenses.

Dr Chen Shih-Chung stressed that changing the reimbursement rules can help reduce the total NHI expenditure.   Hence, the payment regulations should be considered a tool of health promotion.  He instructed all agencies to have open-minded and progressive thinking and collaborate with each other.

The MOHW’s reform proposal is backed by Dr Yang Chih-Liang, a former health minister.  He pointed out that the promotion of preventive medicine is now a worldwide trend. Dr Yang hopes this reform can be achieved with the authority’s determination. 

【2021-03-28 / United Daily】