Major disagreements remain among lawmakers and between some legislators and the Executive Yuan on issues concerning the proposed second-generation national health insurance (NHI) premium system despite a pledge by Legislative Speaker Wang Jin-pyng (王金平) to push through the bill next week.
After a lengthy debate on Friday, legislators across party lines reached a preliminary consensus on the second-generation NHI, agreeing that consultations on the issue should be completed by tomorrow, paving the way for the line-by-line reading of the bill before it clears the legislative floor the following day.
The amendment to the National Health Insurance Act (全民健康保險法) mainly involves a new scheme for calculating premiums based on total household income, rather than the current system, which is based on an individual’s salary.
While the change to a household income-based premium system has been agreed to by lawmakers, the parties lack consensus on the definition of household income.
The Democratic Progressive Party (DPP) caucus suggested the inclusion of capital gains, overseas incomes and retirement pensions available for civil servants and teachers in household incomes, which was supported by some Chinese Nationalist Party (KMT) lawmakers, but opposed by the Department of Health (DOH) and the Executive Yuan.
Eva Teng (滕西華) Spokesman of the Consumers’ Foundation and the National Health Insurance Civil Surveillance Alliance spoke in favor of the DPP caucus’ version.
The new scheme would not be fair if total household income was defined as in the taxation system, which excluded the types of incomes suggested by the DPP, because it does not impose higher premiums on the wealthy, Teng said.
KMT Legislator Yang Li-huan (楊麗環) said she supported the DPP caucus’ version only with regards to the inclusion of pensions of civil servants and teachers.
The government cited difficulties in calculating overseas incomes and capital gains.
Without having a specific premium rate written into the bill, the DOH planned to cap the premium rate at 2.7 percent, saying the premium rate would be able to expand the premium base from the current NT$3.27 trillion (US$105.6 billion) to NT$5.2 trillion.
The DOH has suggested two options for calculating premiums — the first is to either multiply the basic premium by the number of household members or total household income by the premium rate, whichever is higher; the second is a sum of the two different premiums calculated in the first options, but at a lower premium rate in comparison with that in the first option.
DOH Minister Yaung Chih-liang (楊志良) suggested capping the premium rate at 2.3 percent, while DPP Legislator Huang Sue-ying (黃淑英) said her caucus opposed leaving the decision of premium rates to the DOH’s discretion.
Lawmakers across party lines also agreed to repeal the drug co-payment policy in the second-generation NHI scheme. Medical institutions in the future would be prohibited from demanding those insured to pay out of their pockets for certain types of drugs, which in the past was criticized as an unfair scheme because poorer people would not opt for more expensive drugs.
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