Regarding the recent challenges at the National Health Insurance system, including adjustments to drug prices, drug shortages and the reimbursement pricing of orphan and instruction drugs, among other issues, former National Health Insurance Administration Director General Lee Po-chang said that stakeholders must improve the allocation of healthcare earnings to addressing the root cause of the problems.

Former Director General Lee said that the global budget covers the reimbursement of medical services as well as drugs, and that a balance must be achieved between the two. However, currently no changes to drug copayments have been implemented, with a Drug Expenditure Target (DET) remaining the sole mechanism to control spending on drugs. At the same time, when an excess number of medical points is awarded for medical services rendered, hospitals often dilute the value of medical points to contain the total amount of claims. Such a practice has continued to deepen dissent among medical service providers and drug makers. Former Director General Lee added that as the DET does not address the causes of drug waste, but only contains drug spending by lowering drug prices, it remains a highly controversial measure. Furthermore, under a free market economy, as long as there are adequate profits to be made, in theory drug shortages should not be possible.

Besides, Former Director General Lee said that the opposition against raising NHI premiums among the medical community is in fact motivated by politics, and that the government should not be solely responsible for the issue, while the public needs to be more aware of the user pays principle. The full implementation of the referral system and copayment adjustments, as well as the optimization of technologies will not only enable the sustainable development of the NHI, but also strengthen the government’s position in carrying out policies.

[2023-3-19/Liberty Times]