The MOHW officially confirmed the implementation of the new NHI co-payment scheme, which may come into effect from July 1st. The NHI has been under financial strain due to an aging population and advances in medical technology. Dr Hung Tzu-Jen, the President of the Taiwan College of Healthcare Executive, expressed that, to provide better healthcare for the public and to ensure the quality of care, the authority needs to increase the growth rate of the NHI global budget and increase the scope and strength of the co-payment scheme.
Dr Hung stressed that healthcare providers would suffer if the growth rate of the NHI global budget remains static. He pointed out that the MOHW’s advance announcement about the implementation of NHI co-payment and the containment of NHI global budget growth highlights the urgency of an NHI reform. In the post-pandemic era, the WHO urges all governments to increase investment in healthcare so as to create a resilient public health system. However, the authority in Taiwan decided to go against the international trend by curbing the growth of NHI global budget.
Dr Hung continued that low growth in the NHI global budget will inhibit hospitals from updating the equipment and retaining healthcare professionals. As a result, it will affect the quality of healthcare. After the pandemic, patients resume their usual hospital visits; and the increased service volume depreciates the reimbursement point-value. The NHI reimbursement point value in the greater Taipei area dropped from NT$0.78 in the 4th quarter of 2022 to NT$0.75 in the 1st quarter of 2023; and it continues to fall.
The co-payment scheme was originally designed to bill for out-patient medications, A&E services and medical tests. Now, it applies only to out-patient medications and A&E services. Dr Hung expressed that the reduced implementation scope limits the impact of the scheme. To sustain the development of the healthcare system, the government needs to act more boldly and put the NHI point-value on the NHI Board Meeting agenda for thorough discussion.
Dr Wang Hung-Yu, the Standing President of the Taiwan Medical Association, said that the NHI provides a comprehensive coverage, including many preventive care programs. The NHI is actually funding the public health services. It is necessary to review the NHI reimbursement items.
Dr Chu Yi-Hung, the President of the Taiwan Community Hospital Association, mentioned that the NHIA should tackle the financial problems by creating sources of income, as well as controlling costs. In the aspect of increasing income, the government should lift the upper limit of the NHI global budget growth rate, currently at 6%. This will requires a law amendment. In the aspect of controlling cost, the NHIA could consider implementing a balance billing system for expensive new drugs and new medical devices which are not yet covered by the NHI due to high costs. Alternatively, the government could solicit a centralized procurement for new drugs and new medical devices and leverage price negotiation to expedite the access to new treatments at affordable costs.
【2023-05-18 / United Daily】
