Wed, Nov 24, 2004 - Page 4 News List

Researchers discuss gaps in medicare

FAIR CARE Academics and activists discussed changes to the health insurance program to ensure that all citizens receive medical coverage


A panel of academics and social welfare activists yesterday discussed whether National Health Insurance program (全民健康保險) should be converted into a social welfare system available to all citizens.

The panel discussion, held by the Creation Social Welfare Foundation, sought to determine why some people had not been covered by so-called universal health insurance.

According to the study, three groups of people do not receive health coverage: those who live abroad, young adults between the ages of 20 and 30 who change jobs frequently and people who cannot afford to pay insurance premiums.

"The first two groups do not have financial reasons for not being insured, the last group, which is made up of about 230,000 individuals, is not insured due to economic reasons. They may have unstable incomes, be unemployed or have a low social status," said Lin Ji-Ping (林季平), a researcher at the Academia Sinica's Research Center for the Humanities and Social Sciences, who participated in the study. These 230,000 individuals account for one-quarter of the total uninsured population, according to the study.

The Judicial Yuan's Grand Justice Interpretation No. 472 (Jan. 29, 1999) stipulates that the state shall give appropriate assistance and relief to those who cannot afford to pay premiums, and shall not refuse to pay benefits, in order to fulfill the constitutional purposes of promoting national health insurance, protecting the elderly, the infirm and the financially disadvantaged.

The Council of Grand Justices provides legal interpretations of the Constitution.

Based on the interpretation, the academics said that the term national health insurance should be defined more clearly.

"In Taiwan, the emphasis of this health insurance policy is placed on the word insurance, and not on the word national [universal]. Therefore, it is an insurance system, not a social welfare system. However, what this particular interpretation by the Grand Justices says about national health insurance is in contrast with the actual practice," said Lin Wan-I (林萬億), a professor of social work at National Taiwan University.

The National Health Service (NHS) of the United Kingdom, Lin said, functions as a social welfare system.

"The NHS does not work like an insurance program, but as a social welfare system, and the focus of the UK's system is on all," Lin said.

Lin suggested that a portion of tax revenues be allocated to Taiwan's national health program if the program was in fact meant to serve the entire population.

"In Sweden, about 7 percent of one's income goes to the national health program. Taiwan could adopt this structure in which money flows out of one's income [as tax] and into the program, instead of actually having to pay for premiums. This way, the entire population would be included in the health program," Lin said.

Michael Chen (陳孝平), a social welfare associate professor at National Chung Cheng University, suggested treating the three groups that fall outside the system like the unemployed in terms of insurance coverage.

Chen explained that the current national health insurance policy covered unemployed people for a maximum of 30 weeks. However, at least half of the unemployed population was actually out of work for a longer period, and therefore the policy should be re-adjusted.

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