As the National Health Insurance (NHI) system’s financial shortfall continues to grow, Minister of Health and Welfare Chen Shih-chung on June 20 pitched a proposal to expand the scale of the NHI for discussion. Reportedly, apart from raising premiums, the system could be expanded under the same model as the government’s initiative to eradicate HCV, where additional funding was drawn from the budgets of government agencies.

Minister Chen in a recent interview said that while he is aware of the immense difficulties of raising NHI premiums , doing so is necessary, emphasizing that in addition to higher premiums, additional revenue will also be drawn from long-time expats based on their overall incomes.

Fielding media questions about adjusting NHI premiums, Minister Chen said that there are no doubts about the need to increase the scale of the NHI to address funding shortfalls, however, specific plans to accomplish the goal are still under discussion to meet stakeholder expectations.

Regarding the proposal to base premium contribution on household income, Minister Chen said that ongoing discussions have yet to cover the topic, adding that collecting the required household data to implement household-based premium contribution would be difficult and require caution.

In a telephone interview, Department of Social Insurance Director General Shang Tung-fu said that as the NHI global budget continues to increase yearly, maintaining the system’s finances has become increasingly difficult, in particular as the system’s fiscal shortfall has continued to widen. Director General Shang said that the health ministry is planning three new initiatives, namely replacing hospital-based caregivers with attendant nurses, whose services will be covered under the NHI’s reimbursement scheme; promoting community-based care for patients with psychiatric and chronic psychiatric conditions; and strengthening care provision for patients with general chronic conditions.

Director General Shang said that as the three new initiatives are likely to result in significantly higher NHI expenditure, the government is planning to allocate agencies’ budgets to bolster the NHI’s limited funding as seen in the funding scheme for HCV. Director General Shang said that although the NHI will not be the sole bearer of the additional expenditure, the anticipated scale of the budgets to be allocated have not been estimated at this time.

Regarding NHI premiums, Director General Shang said that should the NHI’s safety reserve fall below the equivalent of 1.5 months’ NHI expenditures during NHI premium discussions in November, the National Health Insurance Committee will be legally required to consider premium increases to ensure that safety reserves reside at a level equivalent to 2 months’ NHI expenditures.

[2020-06-20 / CNA]