Reported Chiang Hui-Chun from Taipei

In order to promote the graded healthcare, the MOHW plans to restrict the service volume of treating ailments in medical centers.  The MOHW has classified over 8000 diseases as ailments, including abortion, hypertension, TB, etc.  But doctors are worried about rows with patients over the classification of diseases because patients cannot judge whether their conditions are ailments of severe problems. 

Tsai Shu-Ling, Deputy Director of the NHIA, expressed that the NHIA has commissioned 23 medical associations to sort diseases according to the severity of the diseases.  The NHIA will discuss the lists with experts to form a consensus.

The NHIA has referred to the ICD-9 to include 2000 ailments in the provisional “Definition of Primary Care for Declaration”.  This year, the NHIA decides to follow the ICD-10 and include 8653 diseases in the scope of the primary care.   In the future, most patients will have to visit primary care clinics for initial diagnosis and treatments.

Hu Rei-Hung, Director of the Medical Affairs Department of the NTUH, expressed that the NHIA’s scope of ailments is too broad.  It includes many statutory infectious diseases.  Also, he added: “How can hospitals control the service volume and keep it within the cap?  Should doctors decide which patients to treat by the luck of a draw?”

Dr Hung Hui-Feng of Hsin-Kong Memorial Hospital said that how to list the health conditions of patients with multiple illnesses will become crucial. For example, putting hypertension on top of the list will make the case an ailment case, while putting diabetes on top of the list will make the case a severe case.   It is very tricky, said Dr Hung.

Huang Shu-Ing, the Convenor of the NHI Supervision Alliance, stressed that the government should have a clear definition of the graded healthcare and properly educate the public before putting the system into practice.

【2016-12-08/ United Daily News】