Responding to punishment of the Taichung Veterans Hospital last week by the Bureau of National Health Insurance, some 1,500 community hospital representatives will take to the streets tomorrow to protest the bureau's fixed-budget policy.
The move marks an escalation in a long-running conflict between the bureau and the nation's hospitals. The bureau last Thursday disqualified Taichung Veterans Hospital from its Hospital Excellence Plan, which provides bonus funding, after investigating complaints of poor service.
"The fixed budget is driving hospitals out of business," said Hsieh Wu-chi (
The average insurance payment benchmark for hospitals was 0.95 last year -- meaning that 95 percent of expenses claimed by hospitals is refunded.
The benchmark for community hospital outpatient services, however, dropped to 0.72 at the beginning of the year.
"For community hospitals, whose income relies heavily on outpatients, this is little different from cutting us off," Hsieh said.
Hsieh accused the bureau of not allocating resources to hospitals fairly. He said that former bureau president Chang Hong-jen (張鴻仁) had not given hospitals a say in how to divide the NT$350 billion insurance budget among medical centers, corporate-funded hospitals, community hospitals and private clinics.
The association will demand that Chang step down and a large-scale revision of the policy be undertaken.
The association said that small and medium-sized hospitals had borne the brunt of the policy.
"Unlike most large hospitals funded by rich corporations, community hospitals do not enjoy strong financial backing. Nor can community hospitals drive down costs by increasing the volume of services," association member Luo Yong-da (
Luo argued that most community hospitals are funded by individual doctors who dedicate themselves to their hometowns. Lacking promotional strategies and medical management skills, these hospitals would be the first to drop out of the medical market.
"Community hospitals are facing a crisis of survival," Luo wrote.
The national health insurance program was launched a decade ago, and more than 200 community hospitals have closed down since then.
Hsieh warned that if the bureau did not promptly increase insurance payments, around 300 of the nation's 400 community hospitals will soon go out of business.
Last Tuesday, the association said it would demonstrate in front of the Executive Yuan, the Legislative Yuan and "ring the doorbell" at the Control Yuan and accuse Chang of wrongdoing.
If the government does not res-pond, the association said it would take its case to the Presidential Office toward the end of the month.
In response, the bureau yesterday said it would continue negotiations.
"We will not ignore the demonstration. We will keep on searching for a solution that is best for all," bureau vice president Lei Chin-hsiang (
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