Wed, May 10, 2000 page2

• Legislators want national health insurance overhaul

  HEALTH MATTERS KMT lawmakers say that hikes in national health insurance rates are not necessary, and that the system's inefficiency should be tackled

  • By Stephanie Low / STAFF REPORTER
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  Recent reports about possible raises in the premium rate for National Health Insurance have again triggered heated discussion about a potential waste of medical resources underlying the system.

  Official records show that medical expenditures total around NT$25 billion per month, and security reserves have been used to reimburse the shortfall of incomes, which are basically premiums paid by the insured.

  According to an actuarial report from the National Health Insurance Bureau, security reserves will be almost used up by October based on the current financial conditions.

  The report suggest that the premium rate, which at present is 4.25 percent, may have to be raised to 4.75 percent at least, to cope with the problem. At the maximum, the rate may need to be raised to 5.38 percent.

  Following the DPP's open opposition to the proposal, a group of KMT lawmakers yesterday also protested against what they called an "irresponsible move" by the National Health Insurance Bureau.

  KMT legislators Chen Horng-chi (陳鴻基) and Shyh Jong-shyong (徐中雄) argued that raising the premium is simply unacceptable when the bureau has not even tried to stop the immense waste of medical resources.

  "It's ridiculous to talk about raising the premium rate, but turn a blind eye to the underlying problem," Shyh said.

  Citing statistics from the bureau, Chen and Shyh said that medical expenditures have grown by NT$43.5 billion over the three-year period to 1999.

  Of this, NT$43.5 billion, NT$16.3 billion was spent on medicine. Chen said owing to the insufficiency of the present system, an estimated NT$20 billion of the spending on medicine is simply improperly earned by some hospitals every year.

  The bureau has set a standard price for each kind of medicine, on which it bases reimbursements for spending on medicines by contracted hospitals and clinics.

  However, as larger hospitals are usually able to purchase their medicines at discount prices for bulk purchases, the payment that they receive from the bureau can in fact be higher than what they actually spend.

  For some smaller hospitals and clinics, the standard prices set down by the bureau may cause significant losses.

  Chu Tzer-ming (朱澤民), vice president of the Bureau of National Health Insurance, admitted that the problem does exist, but added that this is inevitable within the system.

  Chu said if the payment is made based on the actual price, there will be other problems, too.

  For example, hospitals and clinics may deliberately prescribe expensive medicines for their patients or prescribe more than they actually need, Chu said.

  Chu said to cope with the present system's problems, the bureau has conducted regular surveys on medicine prices and lowered its standard prices on two occasions.

  "This has helped reduce the spending on medicine by some NT$1 billion," he said.
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