Pharmaceutical News
Scholars recommend 3 directions for sustaining the NHI

Is the healthcare in Taiwan really world-class?  Many scholars do not think so.  In fact, Taiwan’s average life expectancy is growing more slowly than that of Japan and South Korea.  Scholars pointed out that under the NHI Global Budget system, hospitals’ profit margins are limited, resulting in outdated facilities and staff shortages.  The healthcare standards in Taiwan are actually going backwards.

The New Taipei City Medical Association held a forum on the 7th to discuss the sustainability of the NHI.  Dr Lin Heng-Yi, Superintendent of the Taipei Cardinal Tien Hospital, suggested that the NHI should consider working with commercial insurance companies to bridge the gap in insurance coverage, for example, new cancer drugs, immunotherapies, etc.  It will not only benefit the insured, but also will reduce the NHI’s financial burden.

Dr Lee Po-Chang, the Director General of the NHIA, expressed that the NHI spending on cancer drugs has the highest growth rate of all drug categories.   According to the data in 2021, the NHI provided 154 cancer drugs which had an annual cost of over NT$40 billion; and this number is increasing year by year.  Statistics show that over 70% of the public (about 16.79 million) have private insurance policies.  However, there are often disputes over claims as many of the insured are unclear about the terms and conditions of their insurance plan.  Dr Lee recommended purchasing a “pay-as-you-go” hospitalization insurance plan and a cancer treatment plan.

Dr Lin suggested that the NHI should create diversified payment methods.  Taking prostate hypertrophy surgery as an example, endoscopic surgery is fully reimbursed by the NHI, while the Da Vinci Surgical System has to be paid by patients.  If the NHI works with commercial insurance companies, patients may be able to bill their insurance provider for the balance.

Prof Hsieh Chee-Ruey of the Department of Public Finance of Feng Chia University, mentioned the “3 arrows for NHI reform”.  First of all, the government should amend the law to increase the government’s investment in public health.  The NHI finance should not be a self-sufficient system which depends solely on the insured.  Secondly, the NHI should incorporate commercial insurance plans into the system to provide extra coverage on expensive drugs and treatments.  Finally, the NHI should work on cost control.  The government should establish a national clinical trial center to remove ineffective treatments and drugs from the NHI Benefit Scheme. 

Dr Hung Tzu-Jen, the Standing Director of the NHCA, suggested that the government should create a MOHW Think Tank Platform, like the one launched in South Korea, to offer clinical trial results as a reference for NHI reform. 

The scholars urged the government to stop boasting about the quality of the healthcare in Taiwan.  Instead, the government should invest more in public health, for example setting a ring-fenced or special budget and increasing the ratio of health spending to GDP. 

【2022-08-07 / United Daily News】