The National Development Council (NDC) towards the end of June approved a growth range between 2.907 percent and 4.5 percent for the 2021 National Health Insurance global budget, with the 4.5 percent upper limit being the lowest in the past seven years. According to the growth range, the global budget could reside between NT$774.5 billion and NT$786.5 billion, or NT$21.9 billion to NT$33.9 billion higher than the 2020 global budget. In addition, only a NT$10 billion portion of the 2021 global budget will be decided by the outcome of ongoing negotiations between National Health Insurance Committee (NHIC) members.
NHIC member Chu yi-hong said that while the National Health Insurance Administration (NHIA) and hospital representatives’ draft global budgets are mostly in alignment, hospitals are still vying for more funding, with medical centers and regional hospitals hoping for a NT$800 million to NT$1 billion in additional funding to make up for their burdens of providing emergency and critical care and fulfilling the government’s mandate to carry out the patient referral system. Community hospitals are also looking for NT$400 million to NT$500 million in additional funding to bolster provision of care to patients with chronic disease as well as providing post-acute care. However, the proposals have not gained the consent of payers representatives, who said that funding for emergency and critical care has already been increased several times, rising above NT$10 billion.
NHIA Director General Lee Po-chang said that while there are lingering issues surrounding funding for patients with sudden, catastrophic and rare diseases, there is little room for additional funding due to the caps on the global budget placed by the NDC. Under these constraints, the best solution is to cut unnecessary medical treatments to raise the value of medical points so that medical institutions receive the same amount of funding while lowering the amount of treatments they provide.
Director General Lee said that in October the focus will be on adjustments to reimbursement standards, including dispensing fees for pharmacists and diagnostic fees for internal medicine physicians, and well as fees for the nursing staff at intensive care units and those providing care for respiratory patients in a bid to provide people doing these tough jobs with the compensation they deserve. Recent media reports have said that the NHIA is planning to allocate close to NT$12.3 billion, out of additional funding resulting from changes in the medical service cost index, toward 300 types of emergency and critical care services, representing the largest increase in recent years.
NHIC Member Chu said that medical services providers have all been strained by rising costs in the past two years and that the additional funding should not be allocated toward adjusting reimbursement standards. While hospitals on the whole have been bearing higher costs, the proposed changes to the reimbursement standards will not benefit all medical service providers; furthermore, some medical departments will benefit more than others due to backing from medical societies with greater influence. Therefore, instead of adjusting the reimbursement standards, it would be fairer to allocate the resultant budget windfall back into the global budget.
[2020-08-23 / United Daily News]
