Written by Lee Po-Chang, the Director General of the NHIA

The NHIA released the latest proposal for the adjustment of the NHI co-payment, which was drafted based on the principles of gradual reform, sustainability and the care for the vulnerable.  Its objective is to allocate more resources to those who are really in need, for example patients with severe injuries, cancers or rare diseases.  According to Dr Chen Shih-Chung, the MOHW Minister, a higher co-payment will help to increase the public’s awareness of the treatment costs and, therefore, modify their health seeking behaviour.  Finally, it will improve the quality of healthcare and the relationship between doctors and patients, said Dr Chen.

To reduce unnecessary treatments

The introduction of “User Fee” is critical to the reform of the healthcare system in Taiwan.  The healthcare industry and public should have a positive attitude to it and work together to reduce any unnecessary health seeking behaviour, so that new drugs, new technologies and new special materials could have a chance to be listed in the NHI Benefit Scheme.

Many patient groups have long been campaigning to the NHIA for the access to new treatments, either an expanded reimbursement scope or the list of a new product.   The NHIA always devotes the attention to the formulation of measures for helping the financially vulnerable groups and for reducing the hurdle of their access to healthcare. 

To care for the vulnerable

The members of the NHI Board strongly support the creation of an NHI charity account, which will provide financial aid to the vulnerable groups and to prevent a vicious circle linking poverty and poor health.  

As a surgeon, I know very well how important it is to relieve a patient’s pain and suffering in a most practical and efficient way.  A triage system which cares for the vulnerable and respects the healthcare professional has always been the core principle of the NHIA. 

This proposal to increase the co-payment is not the only measure for relieving the NHI from its financial difficulties.  The adjustment of co-payment will only generate an extra of NT$10.73 billion a year; however, the biggest saving is from patient’s change of health seeking behaviour.  If each patient reduces the hospital visits by just once, it will save over 37.8 billion NHI service points.

To fully implement the triage system

Most of the drug fees for cancers, rare diseases and haemophilia are claimed by medical centres (60%), while most drug fees for hepatitis C were claimed by regional hospitals (41.6%).  As for the primary care clinics, they claimed the most drug fees for the “3-high conditions” (30.4%).  These figures indicate a form of triage has been established in the healthcare system.  The implementation of the co-payment system will further strengthen the triage system. 

According to the “Zero Price Effect”, a tiny increase in the price from zero will cause a significant reduction in demand. Therefore, a small co-payment will be sufficient to deter patients from unnecessary health seeking behaviour.

【2022-03-21 / United Daily 】