The Ministry of Health and Welfare (MOHW) on July 22 tasked the National Health Insurance Committee (NHIC) to coordinate the drafting and allocation of the 2020 National Health Insurance global budget while adhering to the rate range between 3.708 percent and 5.5 percent set by the Executive Yuan.

After the National Health Insurance (NHI) global budget exceeded NT$700 billion in 2019, continued expenditure growth is expected in 2020 as pressures from Taiwan’s rapidly ageing population, rising healthcare costs and falling birthrates come to bear. With nonnegotiable factors estimated to drive up next year’s expenditure by 3.708 percent at the minimum, there is little headroom left from the 5.5-percent cap on budget growth. This year’s NHI global budget negotiations were more difficult than in previous years. It took the NHIC a 16-hour meeting to forge a consensus on the dentistry and Chinese medicine departments and some other budget items, while dissent remain among hospitals and Western clinics departments.

In a bid to accelerate the elimination of HCV, the 2020 HCV budget for hospitals, Western clinics and other related budget items has been set at NT$8.166 billion, NT$1.63 billion higher compared to 2019 spending levels to benefit an estimated 51,000 patients in total.

Although the NHIC did not reach a consensus on the hospital portion, provider and payer representatives proposed very similar amounts, differing only on HCV diagnostic fees for patients under a regiment of orally administered direct-acting antiviral (DAA). Payer representatives argued that the use of DAA drugs will significantly cut the need for funding to treat patients’ complications, and that cost savings should be more than enough to cover the cost of diagnostics. However, provider representatives said that diagnostics should be added as a budget item to avoid crowding out funding for other medical services.

For Western clinics, the difference between payer and provider versions stood at NT$1.914 billion. Western clinic representatives have appealed for larger expansion of their budget to fund new medical technologies, expanded drug reimbursement scope, treatment for HCV and HCV complications, among other items.

Following the negotiation, the NHIC will submit its proposed budget for departments that are in agreement, including dentistry and Chinese medicine and other budget items for the MOHW’s approval. Budget proposals for the hospital and Western clinic departments will be submitted to the MOHW for decision. The NHIC’s proposed 2020 budget is listed below:

【2019-09-27 / National Health Insurance Committee】