President Ma Ying-jeou (馬英九) yesterday approved a proposal to increase National Health Insurance (NHI) premiums starting on April 1 and also instructed the Cabinet to present a plan in two years on revamping and introducing a second-generation health insurance plan.
A proposed second-generation health insurance measure would base the calculation of the premium on the insured’s total household income as opposed to the current system, which is based on the insured’s insurance subscription, the level at which an employer registers an employee for health insurance, which is usually roughly equivalent to an employee’s monthly salary.
Department of Health (DOH) Minister Yaung Chih-liang (楊志良) previously disagreed with Ma and Premier Wu Den-yih (吳敦義), who favored a multiple-rate system that would see higher premium rates for higher monthly income earners.
Yaung said changing the system from the current flat rate would not be in line with the National Health Insurance Law (全民健康保險法) and would necessitate an amendment to the act.
After hearing Yaung’s report yesterday morning at the Presidential Office, during which Vice President Vincent Siew (蕭萬長), Legislative Speaker Wang Jin-pyng (王金平) and were also present, Presidential Office Spokesman Lo Chih-chiang (羅智強) said Ma agreed with Yaung to maintain the flat rate system for now, but said that lower monthly income earners would receive a larger subsidy from the government than those who have relatively higher monthly earnings.
To make the program more sustainable, Ma also ordered the Executive Yuan to present a draft plan on a second-generation health care program within two years, Lo added.
Under Yaung’s proposal, Lo said 78 percent of the insured population would be spared from the price hikes, while the government would work to subsidize some of those affected.
Yaung resigned on Monday last week, saying he was unable to deliver on Wu’s request to ensure that 75 percent of the insured population be spared from the proposed increase in premiums. The resignation was not accepted.
Lo said Ma yesterday again asked Yaung to remain in his post.
Yaung told a separate press conference held at the Executive Yuan later yesterday that he would stay, but added that he hoped to resign when the current legislative session ends, probably in June, whether or not he is able to introduce a second-generation national health system that would ensure wealthy people pay more in premiums.
“I will work hard during this legislative session to push for the passage of a second-generation national health insurance system. If this passes, I would have accomplished my mission. If not, it would be because of my incompetence. There should be someone more capable than me to be DOH minister,” Yaung said, with Wu sitting next to him.
Yaung said the premium hike, which will go into effect on April 1, would result in an increase of NT$52.2 billion (US$ 1.65 billion) in annual premiums and thus help ensure the financial stability of the NHI program for at least two years.
Bureau of National Health Insurance (BNHI) data showed that the NHI system recorded a deficit of NT$58.8 billion at the end of December last year, and this is expected to almost double to NT$101.5 billion by the end of this year, with an accumulated burden of NT$1.8 billion in bank loans by the end of this year.
Currently, the premium for an insured employee is set at 30 percent of 4.55 percent of the insurer’s registered insurance subscription, with the government shouldering 10 percent of the cost of the insured and the employer paying the remaining 60 percent.
Under the revised plan, the current 4.55 percent flat-rate will be raised to 5.17 percent, and the highest insurance subscription level will be raised from NT$131,700 to NT$182,000.
The new system will see the government subsidize those in the NT$50,600 and below insurance brackets to offset the impact of the increases in the premiums.
A total of NT$12.1 billion in government funds will be used to cover all the extra financial burden of 78 percent of low-wage earners in the NT$40,100 and below brackets, and help another 9 percent of the insured in the NT$42,000 to NT$50,600 brackets pay 20 percent of their extra premiums.
The BNHI said premiums for those in the NT$42,000 insurance bracket will rise to NT$636, from the current NT$573, while the maximum increases for those insured in the NT$182,000 bracket will rise to NT$2,823, from NT$1,798 now.
Later yesterday at a separate setting, Ma, in his capacity as chairman of the Chinese Nationalist Party (KMT), promised to complete the health premium reform within the shortest period of time and make the health insurance program sustainable.
“We finalized the new health insurance premium plan this morning, and the public applauded the negotiations,” Ma said at KMT headquarters after meeting with KMT caucus leaders at the party headquarters.
“I hope we can complete the health insurance reform as soon as possible, and make the health insurance system, which is the pride of Taiwanese, sustainable in the future,” he said.
ADDITIONAL REPORTING BY MO YAN-CHIH
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