Fri, Nov 17, 2006 - Page 2 News List

Forum tackles increasing challenges facing the NHI

By Angelica Oung  /  STAFF REPORTER

Faced with the twin problems of rising costs and a growing deficit, how to get more value out of what the nation spends on healthcare was the hot topics at the National Health Insurance Civic Surveil-lance's (NHISCA) one-day forum on Wednesday.

Currently, care providers are paid by the National Health Insurance (NHI) according to the amount of medical services they administer.

Experts argued that this hurts incentives and results in substandard medical outcomes.

"We have to expect self-interested behavior," said National Yang-Ming University's associate professor Lee Yue-chune (李玉春).

"As long as we only pay for service, we are going to have problems with overmedicalization and not enough attention on preventative care," he said.

Lee said the trend in OECD nations is toward paying for performance rather than services.

She added that by "putting patients into diagnosis-related groups (DRG), we can compare the efficiency of medical care providers more transparently."

Another topic discussed was the NHI's pharmaceutical policy.

In a recent move to curb costs, the NHI lowered the price it pays for drugs across the board, with the exception of drugs which are still under patent.

"The NHI has too much power over which drugs are allowed or not allowed on the market" said Huang Weng-foung (黃文鴻), professor at Yang-Ming University.

"We need more options for those who wish to pay out of their own pockets," Huang added.

Democratic Progressive Party Legislator Wang Jung-chang (王榮璋) also saw problems with the price difference in pharmaceuticals, characterizing the profits that hospitals make as a "kickback."

However, there might be a limit to what efficiency-increasing and loophole-closing measures can do for the NHI.

"The US spends roughly 15 percent of its GDP on medical care while we spend only six percent," said Department of Health Deputy Minister Chen Shih-chung (陳時中).

"We need to seriously look at whether we're investing enough in the health of our nation," Chen said.

"We know it is inevitable that medical care costs will rise," Wang said. "But people will only willingly open their pockets when they trust that the extra money they pay will be put to good use."

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