Following the Executive Yuan’s proposal of a second-generation health plan, the Consumers’ Foundation yesterday called for measures to prevent dishonest reporting of pharmaceutical prices to improve health finances.
As of Apr. 1, the premium rate for national health insurance has risen to 5.17 percent.
However, the Executive Yuan’s plans to launch a second-generation health plan to address the funding problems and make premium charges fairer has prompted healthcare reform groups and consumer groups to call on the government to deal with the issue of dishonest or inaccurate reporting of drug prices.
The consumer rights watchdog estimated that a NT$7.2 billion (US$225 million) gap exists between the actual price of drugs prescribed and the reimbursement received by medical institutions each year.
This is caused by medical institutions using simplified forms to report expenses of lower-priced drugs, which reports drugs at a set price and may cause figures to become inflated because of inaccurate methods of reporting.
Foundation chairman Hsieh Tien-jen (謝天仁) yesterday urged authorities to forgo the system of using simplified expense reporting and instead cap drug reimbursement amounts at current market prices.
He added that large hospitals can negotiate better prices with pharmaceutical companies as they buy drugs in bulk, while small clinics have less negotiating power.
The system “sucks the blood out of small clinics and fattens up large hospitals,” he said.
If medical institutions were required to report the exact price they paid for drugs, the problem of over-reimbursement would be minimized, Hsieh said.
“Why do national health insurance funds stay in the red despite premium hikes? Because the government turns a blind eye to the black hole [of the drug expenditure gap],” he said.
“If [the proposed second-generation health plan] is only concerned with reaching into people’s pockets, rather than dealing with wasteful expenditure, the deficit problem will always exist despite premium rate hikes,” Hsieh said.
At a separate setting yesterday, Chinese Nationalist Party (KMT) Legislator Lo Shu-lei (羅淑蕾) urged the Department of Health (DOH) to consider individuals’ profits from property or stock investment as part of their income when calculating National Health Insurance fees in the second-generation insurance scheme in a bid to make big earners pay higher insurance fees.
Lo said the DOH should also present more statistics to support the department’s argument that those who are single should pay higher insurance fees instead of simply asking them to think of themselves as making charitable contributions by paying higher fees.
ADDITIONAL REPORTING BY FLORA WANG
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