The issue of National Health Insurance (NHI) drug pricing again dominated discussions at the Legislative Yuan's Health, Environment and Social Welfare Committee (立法院衛環會) meeting yesterday.
Most of the legislators agreed that hospitals ought to be allowed some bargaining power, but thought the profits currently made at the expense of the NHI, often through backdoor measures, are far too high, while trust in the NHI as guardian of the process has plunged.
"The NHI's basic pricing guideline is inflexible and price adjustments are often out of date by the time they are enacted," said Democratic Progressive Party Legislator Huang Sue-ying (
"You're treating Taiwan's 23 million people as ATMs," berated People First Party legislator Lin Hui-kuan (
Crackdown
After the Tainan District Prosecutors' Office started investigating improprieties related to drug pricing differentials, the NHI cracked down on the practice under which pharmaceutical companies and hospitals collude to keep the drug price they claim to the NHI high while trading kickbacks under the table.
NHI CEO Chu Tzer-ming (
"We're going to make them give that money back," said Chu, while pointing to the form in which hospitals are supposed to detail any "donations," "research funds" and "gift packs" of drugs they might have received from pharmaceutical companies.
Chu also promised to revise the process used to generate basic pricing outlines and set a "claw-back" system in place so that the NHI and hospitals can split any profits from bargaining.
However, a number of observers believe that a more fundamental way of fixing the system is to move away from paying hospitals for every pill or treatment and towards paying for the number of patients with different conditions they take care of.
Underground profit
"Because you have groups with different purchasing power in the market, you're going to have problems with price differentials, trying to close or eliminate the gap will only drive the profit underground" said Lee Yue-chune (
"It is better to pay providers to produce good medical outcomes for patients rather than by the amount of medical resources they consume," Lee said.
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