Sun, Apr 27, 2008 page2

• Groups denounce plans to raise insurance rates

  PREMIUM An official from the health department said the DOH considered research and development when it calculated the costs of the insurance system

  • By Shelley Shan / STAFF REPORTER
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  National health insurance watchdog groups lashed out yesterday against the government’s plan to raise insurance premium rates.

  The plan was proposed by the Bureau of National Health Insurance on Friday, which is obligated to brief the Department of Health (DOH) every two years on the status of the national health insurance system and make suggestions accordingly.

  Based on the proposal, the general premium rate will be raised from 4.55 percent to 5.18 percent per person, registering an increase in payment by 13.8 percent for the insured.

  The bureau also warned if the proposal was not adopted, the accumulated deficits of the national health insurance system would top NT$20 billion this year.

  The bureau also mentioned alternative solutions if the government rejects the first suggestion.

  For one, the premium rate set for co-payment could be raised from 4.55 percent to 5.11 percent instead.

  For medical expenses that cannot be paid through the national health insurance system, the bureau also proposed a NT$2,500 deductibles in which case the insured would have to pay themselves if their total medical expenses did not exceed NT$2,500 a year.

  Should one’s annual medical expenses exceed that amount, the national health insurance would then pay the difference.

  Meanwhile, medication prescribed through the outpatient service would be covered by patients themselves.

  For government workers, teachers and administrative personnel in schools or working people in general, their monthly health insurance premium would increase from NT$437 to NT$497 per month.

  Eva Teng (滕西華), general secretary of the Alliance for the Mentally Ill, serves on the DOH’s supervisory committee of the national health insurance.

  She said she cannot say if the rate was set accurately as it was calculated through a complicated actuarial formula that has taken multiple factors into account.

  However, she said the premium rate was not the issue, and pointed to problems that have yet to be solved under the current system.

  For example, she pointed to the system’s rules that allow wealthy people to pay only a little bit more than people with average incomes, but they get the degree of medical services that other people get.

  “If we do not amend the National Health Insurance Law (全民健保法) and expand the base of the premium rate, then it does not matter if the rate is 6.18 or 7.18 percent. We will never get enough money to pay for it [the national health insurance],” she said.

  She also said the bureau factored in the funding of research and development for large medical centers when it calculated the costs of the insurance system.

  Those costs, she said, should be paid by the government, not by the people.

  She further criticized about the cut-off line set for expenses not covered by the national health insurance, as it would give people the impression that the system only covers the treatment for major diseases.

  Chu Hsieh-kuang (朱顯光), a specialist with the Taiwan Health Reform Foundation, said the insured have the right to know how hospitals and clinics handle the funding allotted to them by the health insurance bureau.

  “The insured should have a say when they decide to reset the rate,” he said.

  DOH minister Hou Sheng-mou (侯勝茂) has said in an interview with the China Times that he opposed the proposal, saying that it was unfair to the general public.

  The same newspaper also quoted DOH minister designate Lin Fang-yue (林芳郁).

  Lin said he would focus on spending each and every dollar paid by the insured more efficiently. He said he does not believe the system will work simply by pouring more money into it.
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