A proposal by medical groups to allocate NT$24.7 billion (US$775.6 million) to fund the National Health Insurance (NHI) system and boost the NHI point value is not feasible, as it exceeds the amount available for negotiations, estimated at NT$17.4 billion, National Health Insurance Administration (NHIA) Director-General Shih Chung-liang (石崇良) said yesterday.
Negotiations on apportioning the NHI global budget of more than NT$900 billion for next year were held on Wednesday, attended by premium payer representatives, medical groups and NHIA personnel.
The NHI global budget next year could range between NT$928.6 billion — an increase of NT$53 billion from this year — assuming a growth rate of 5.5 percent, and NT$911.2 billion, based on a growth rate of 3.521 percent, Shih told reporters.
Photo: Taipei Times
The NT$17.4 billion difference between the high and low end of the forecast range is the negotiable amount from next year’s budget for hospitals, primary Western medicine, traditional Chinese medicine and dentistry, he said.
Negotiations with premium payer representatives would break down if the figure proposed by medical representatives exceeds the negotiable amount, Shih added.
Taiwan Hospital Association chairperson Lee Fei-peng (李飛鵬) said in statement that the proposed NT$24.7 billion could increase the point value and fund NHI payments for basic diagnosis and treatment, including nursing and dispensing fees.
The figure was proposed to balance the books and provide reasonable wages for medical practitioners, as the point value stipulated by current NHI payment standards lacks cost analysis and does not reflect the sharp rise in commodity prices, he said.
Meanwhile, medical representatives said the budget for treatment and medications for rare diseases, HIV infection and hepatitis C infection should be excluded from the NHI global budget and funded instead by the central government budget in accordance with the Rare Disease and Orphan Drug Act (罕見疾病防治及藥物法) and other regulations.
The Taiwan Foundation for Rare Disorders criticized the medical sector’s proposal, saying that Article 33 of the act specifies that the central government’s budget would only subsidize diagnosis, treatment and medications for rare diseases that are “not covered by the National Health Insurance Act (全民健康保險法).”
Nearly 17,000 patients with rare diseases would be affected if they are excluded from the NHI payment system, it said in a statement.
The NHI global budget for this year includes more than NT$10 billion for rare diseases. and it would continue to increase next year with an addition of NT$2 billion funded by the Executive Yuan’s budget, Shih said, promising that rare diseases would not be removed from the NHI global budget.
Premium payer representatives questioned the inclusion of cancer screening fees of nearly NT$3.5 billion into next year’s global budget, which it said should be covered by the Health Promotion Administration.
Shih replied that new cancer cases would increase next year as free cancer screening has been expanded to include more people, so the budget for treatment and medications must be increased for the new cases.
While this could result in a short-term surge, expenditure from treating severe cases would significantly decline over the longer term, he said.
Shih added that NHI premiums would not rise next year, despite increases in dispensing and other fees as the global budget would be enough to cover the extra amount.
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