Opposition talks tough on health-fee hike

The debate over the new fees of the national health insurance system raged on yesterday as opposition lawmakers vowed to stage a massive protest if the Bureau of National Health Insurance insists on raising premium and co-payment rates.

Meanwhile, President Chen Shui-bian (陳水扁) broke his silence on the issue, saying that belt-tightening measures would no longer suffice to keep the bureau afloat.

PFP lawmaker Lin Hui-kuan (林惠官) urged the government to drop the plan to increase health-insurance premiums and co-payment rates, saying the move would enrage the nation's 8 million workers.

The bureau has said it will adjust the fees upward, effective Sept. 1, to help ease its financial woes. The Department of Health (DOH) has voiced support for the planned hikes, which do not require legislative approval to go into effect.

But Lin argued that the legislature adopted a resolution during its last session that orders the bureau to obtain consent from its Sanitation, Environment, and Social Welfare Committee before seeking to tinker with the fee payments.

"The bureau probably thinks it can get around legislative oversight by making the policy change during the summer recess," said Lin, a former labor union leader.

He threatened to organize a massive street protest at the end of August if the government fails to heed his plea.

Fellow PFP lawmaker Kao Ming-chien (高明見) echoed the complaint. He noted that the economic downturn has caused many workers to lose their jobs and that a hike in health-insurance fees would add to their financial burden. Kao, a former neurologist, contended that the proposed fee change promises no solution for the problem of medicine being wasted. Research shows that a quarter of all patients took only half the drugs prescribed and 5 percent of them took none at all.

But Kao said that medical institutions are to blame, as they tend to prescribe loosely in a bid to boost their revenue.

He suggested that the government contribute more funds to the health insurance program, which accounts for only 5.35 percent of the nation's GDP.

"The figure is rather low in comparison with those in advanced countries such as Japan, Canada, Germany and the US," Kao said.

The health insurance program, introduced in 1995, derives almost all its funding from premium revenue that is shared or subsidized, in various proportions, by the insured, their employers and the government.

Beneficiaries are also required to co-pay a portion of medical costs to prevent the wasting and misuse of medical recourses.

During a public appearance, President Chen said it is time to review the program and decide whether it should continue to exist or be terminated.

"Shortly after the power transfer [in May 2000], DOH Director-general Lee Ming-liang (李明亮) warned me that the program was deeply in the red and was in danger of collapse," Chen said. "It has not been easy to keep the service going for the past two years."

The financing of the health insurance system is built around the "pay as you go" concept, which means the collection of premiums and the payment of medical expenses happens at the same time.

"We can't expect the program to stay viable while denying it the necessary funding," the president said.

The health program allows those who are insured to obtain comprehensive medical care -- including health prevention, clinical care, hospitalization and social rehabilitation. As of December 2000, it has enrolled over 21 million citizens, or 96 percent of the population.