Pharmaceutical News
NHIA plans a fixed rate co-payment system

Reported by Huang Wen-Chi from Taipei

The NHIA confirmed on the 12th that the agency is studying the possibility of changing the NHI co-payment from a fixed amount system to a fixed rate system.  The NHIA is currently formulating the plan and will seek support from the MOHW before forwarding the proposal to the NHI Board, social groups and the health industry for wilder discussions.   The law amendment will be based on the public’s consensuses.

Tsai Shu-Ling, the Deputy Director of the NHIA, explained that Article 43 of the NHI Act stipulates that the co-payment can be charged based on a fixed amount or a fixed rate system.  The NHIA is contemplating changing the current co-payment system from a fixed amount charge to a fixed rate charge.  The change is based on the consideration of limited NHI resources and fairness. 

However, the health industry pointed out that the vulnerable groups will be hit hard by a fixed rate system if there are no corresponding measures to help ease the financial burden.  For example, 50% of cancer treatment cost will be unaffordable for many people.

To address this concern, Tsai Shu-Ling pointed out that, pursuant to the NHI Act, the co-payment rate is 20% of the treatment costs for outpatient clinic service and emergency service, and 30%-50% for visiting hospitals without referral.  Tsai stressed that the NHIA will take the vulnerable groups’ interests into account when formulating the policy, for example, by imposing an upper limit for payment. 

Tsai explained that the current fixed amount charge of co-payment is roughly about 11% in terms of a fixed rate charge which is lower than the 20% stipulated by the NHI Act.  Therefore, from 2012 to 2015, the NHI twice proposed a change of the co-payment system from a fixed amount charge to a fixed rate charge.  However, the proposal was suspended due to the lack of consensuses. 

【2018-01-13/ Economic Daily】