The Formosa Republican Association on April 25 held a national affairs forum to discuss the long-term sustainability of the National Health Insurance (NHI) system. In attendance were Vice President Lai Ching-te and former Vice President Chen Chien-jen.

Vice President Lai Ching-te said that in the past two decades, the NHI has faced many challenges, among the most severe is the imbalance in income and expenditure, which was made severe by falling birth rates and a diminishing pool of payers. At the same time, an aging population has increased demand for treatments and new medical technologies. To ensure sustainability, the promotion of disease prevention must be integrated into the NHI. Former Vice President Chen Chien-jen said that the wastage of NHI resources must be addressed by checking redundant diagnostic tests and drug prescriptions. Still, following the adoption of a cloud-based system that tracks patients’ medical imaging data, instances of redundant examinations have seen some improvement.

Taiwan Medical Association President Chiu Tai-yuan attributed Taiwan’s relative success in containing the pandemic to frontline health care professionals, who serve in the crucial role as the first line of defense against infections. However, the interests and welfare of frontline professionals have faced continuous erosion as several large-scale hospitals have setup separate clinics to avoid the referral system. These actions take away resources from clinics and is a problem that should be addressed by the government.

Regarding the referral system, the medical community said that the NHI should ensure that copayments are returned to its legally defined fixed rate. Patients who do not obtain referrals, and those who are wasteful and seek excessively frequent consultations should shoulder a larger share of the expenditure, while access for disadvantaged groups should be ensured through special government budgets.