In what some believe will be the nation's largest-ever uprising of medical professionals, tens of thousands of doctors will step out of their clinics and hospitals today and pour into Taipei's main arteries to protest shrinking reimbursements from the Bureau of National Health Insurance.
"The sharp drop in reimbursements from the Bureau threatens our livelihoods," said the president of the Taiwan Medical Association (
A massive group of 10,000 to 30,000 doctors is expected to take to the streets to protest the fixed budget policy the Bureau has enforced since 2002 to bring ballooning medical costs under control.
PHOTO: CHEN CHIA-MING, TAIPEI TIMES
The doctors plan to assemble this afternoon at CKS Memorial Hall for the protest.
According to the Association, many clinics and community hospitals can barely make ends meet under the reimbursement cap. The Association said that many clinics and hospitals will be forced to close down once the Bureau fixes the reimbursement rate for the 2003 and 2004 fiscal years.
In 2003, the Bureau prepaid about NT$383.1 billion (US$12.12 billion) to the nation's hospitals and clinics. Yet, as the overall reimbursement rate is expected to drop from 95 percent to 85 percent or lower, clinics and hospitals will have to return at least NT$36 billion to the Bureau, an exorbitant payment that could force over 100 community hospitals to shut down.
"For the past two years, we have been able to survive because the Bureau hasn't come up with a reimbursement rate. The consequence of settling the reimbursements is grave for both the government and hospitals," said Hsieh Wen-hui, (
Community hospitals who serve rural neighborhoods will bear the brunt of the payments, Hsieh said. An estimated one-third of 470 community hospitals nationwide will go into bankruptcy once the Bureau demands the return of about NT$10 billion that was prepaid by the government to community hospitals.
Larger medical centers will also feel a financial pinch once the reimbursement rate is lowered.
"For instance, Taipei Veterans General Hospital will have to return about NT$1.5 billion and Chang Gung Memorial Hospital about NT$2.1 billion," said Wu Ming-yen (
Although medical centers will not mobilize staff to join the demonstration, Wu said, center managers will likely give their tacit consent to doctors who ask for a day off today for the rally.
Doctors from the country's central and southern regions will swarm into Taipei, leaving their clinics unattended for a day. Physician's unions in Kaohsiung, Taichung, Nantou and Chiayi have mobilized hundreds of health workers and rented tour buses to join the protest.
"The protest is a chance to bend politicians' ears about our dilemma," said Chen Tsung-hsien (陳宗獻), the deputy convener of today's rally. "It is also a way to urge all citizens to cherish our medical resources."
In response to doctors' mounting discontent, the Department of Health (DOH) has urged hospital representatives to return to the negotiating table.
"It is undeniable that the reimbursement rate has been falling lower and lower since the implementation of [the fixed budget policy] three years ago," said the DOH's secretary-general Lai Chin-hsiang (
According to Lai, falling reimbursement rates are only natural after hospitals vied to pamper patients when the fixed budget policy was implemented. For example, official statistics showed that in-patient service has increased by 10 percent after the launch of the policy in 2002.
The falling reimbursement rate is the bitter pill that certain hospitals must swallow after they expanded their services too much in a freewheeling marketplace, health officials said.
"We are not sliding down a slippery slope," Lai said. "It's an issue of self-discipline. The fixed cap on hospital spending is devised to encourage health service providers to reduce spending rather than attract more patients."
"Hospitals [have been] doling out lunch boxes and dispatch limos to appeal to patients needing dialysis treatments," he said. "There is no reason why taxpayers should pay for hospitals' marketing stunts."
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