In the three consecutive years since 2017, the National Health Insurance (NHI) system has recorded annual financial shortfalls, which rose from nearly NT$10 billion to NT$30 billion at the end of 2019. Currently, despite having enough safety reserve to fund three months of expenditure, estimates suggest that the reserves could dwindle to 1.5 months in 2021. Due to the tremendous financial pressure on the NHI, authorities could be prompted to reexamine copayments.

Tang Yi-wen, a researcher at the National Health Insurance Administration (NHIA), said that due to lags in the reporting of medical expenditure, the NHI’s annual losses for the previous fiscal year are merely estimates. Tang said that in recent years, the NHI’s ballooning financial deficit is driven by an aging population, a rising number of patients requiring critical care, the inclusion of new drugs and medical technology, as well as spending on regions where healthcare and medical resources are lacking. As a result, the NHI’s 4.21 percent expected growth in income has not been able to keep to up with its 4.81 percent growth in expenditure.

Tang said that the NHI has worked hard at cutting expenditure through measures including the reduction of redundant diagnostic testing and bolstering of the patient referral system. The NHI’s global budget for this year is around NT$750 billion, with the safety reserve funds standing at around NT$177.1 billion, enough to tie over about 3.23 months of expenditure.

However, according to the NHIA’s forecast, the safety reserve could fall below the three-month mark as soon as before the end of this year and tumble to below 1.5 months in 2021. When the safety reserve falls below 1.5 months, laws governing the NHI stipulate that premium adjustments must be made according to factors including the growth rate of the NHI’s global budget, preserving the financial sustainability of the NHI, and the outcome of negotiations and decisions of the National Health Insurance Committee.

However, in March this year, in response to questions by Kuomintang Legislator Hsu Chih-jung, Premier Su Tseng-chang replied that there are no current plans to raise or adjust NHI premiums. Other government officials have said that regarding drug prescriptions and diagnostic tests, discussions are underway to implement copayments to fulfil the user-pays principle.

[2020-04-16 / Liberty Times]