Despite the government mapping out a number of solutions to bolster the ailing National Health Insurance (NHI) system that would avoid raising insurance rates, critics say the financial crisis besetting the system remains undiminished.
With bankruptcy for the NHI looming, the Department of Health proposed "tiny fare increases in multiple areas" last month to balance an estimated NT$12.8 billion (US$414.5 million) deficit for this year. The scheme includes an extra NT$11 billion injection from the government, raising the indexed salary ceiling from NT$87,600 to NT$131,700, and increasing the proportion of the assessed salary from 82.42 to 87.04 percent for the nation's military, civil and teaching personnel.
The plan also includes proposals that require revisions to the law, such as a NT$10 health tax levied on each pack of cigarettes, an air-pollution tax, and making people responsible for injuries pay medical fees.
The Bureau of National Health Insurance has also decided to make patients pay more for their visit to hospitals, a plan that the Executive Yuan will implement in October to tap into an estimated NT$6.39 billion in extra revenue.
To attract public support, the Bureau of National Health Insurance has promised that most people will be free from premium hikes for the next three years if all the measures are enforced.
Medical professionals, however, say that the policy will take too long to have an effect and will not save the NHI from its crisis.
"A slow remedy cannot meet an urgent need. Among the proposed solutions, very few immediately provide the money the NHI system needs," said Wu Shuh-min (
Wu said the bureau's funding reserves will be used up this month, whereas the proposed measures would only bring in about NT$3.5 billion by next month at the earliest.
Of the strategies floated, only two -- raising the indexed salary ceiling and increasing the percentage of assessed income for public servants -- will put money in the bureau's pocket in a short period.
"The fate of some of the drafts, such as the NT$11 billion budget and those that require legal revision, is far from certain. The health authority still needs time to lobby legislators and wait for government agencies to process the annual budget. We don't see a timely solution in the government's policy," said Chen Yong-shing (陳永興), superintendent of Kaohsiung Municipal United Hospital.
The policy of minor fare hikes, Chang said, was merely a makeshift strategy devised by a government that does not dare to publicly explain the NHI's financial dilemma and thus risk ruffling the public's feathers.
"The government cannot even ensure that the policy will be enforced within three months to ease the NHI's financial difficulties this year. How can they promise that insurance rates will remain the same for the next three years? It is a false promise that the government has used to pamper potential voters," Chang said.
In a similar vein, former Democratic Progressive Party legislator Shen Fu-hsiung (沈富雄) berated the Cabinet for passing on the NHI's financial woes to the next administration.
"It's clear that the government doesn't have the guts to tackle the NHI within its three-year tenure. The key problem is that the NHI's revenue is failing to match its ever-growing expenditure. Yet neither Premier Frank Hsieh (謝長廷) nor the new director-general of the Department of Health, Hou Sheng-mou (侯勝茂), have got to the heart of the problem," said Sheng, one of the most vocal critics of the NHI.