The Ministry of Health and Welfare is to make public next month a series of suggestions recently compiled by the second-generation National Health Insurance (NHI) program review team, which include requesting that patients pay a fixed percentage of their eligible expenses from outpatient treatment instead of a fixed amount, a ministry official said yesterday.
Chu Tong-kuang (曲同光), director of the ministry’s Department of Social Insurance, made the remarks yesterday, one day after the Chinese-language Apple Daily reported that the suggestions, if adopted, could result in a sharp increase in the basic outpatient care copayment for insured individuals.
The suggestions were tendered in April by the review team, which is headed by former Department of Health minister Yeh Ching-chuan (葉金川). The ministry has yet to publish the suggestions in their entirety and has only sent an outline to relevant legislators for review, according to the report.
Under the National Health Insurance system, patients who seek outpatient services at district hospitals, regional hospitals or medical centers without being referred by local clinics only have to pay NT$80, NT$240, and NT$360 per visit respectively, regardless of the actual costs of the treatments they are prescribed.
However, if the ministry accepts the team’s suggestions, people would have to pay 20 percent of the cost of their outpatient treatments, meaning costs would increase in accordance with the price of the medical care.
For example, an insured person who receives NT$6,000 worth of treatment at a medical center without a prescription at present has to pay a NT$100 registration fee and NT$360 in basic outpatient care copayment, but under the proposed new system, they would have to pay NT$1,200 for the same treatment.
In an attempt to assuage public concerns, Chu said that the ministry would consider imposing a cap on the amount of basic outpatient care copayment a hospital could charge should it decide to adopt the fixed percentage pricing scheme.
According to the report, the review team has also advised the ministry to implement balance billing for medication, set quotas on the number of patients with stable chronic illnesses for whom a large hospital can provide care and to use the combined annual incomes of insured individuals as a basis to determine their eligibility for exemption from the supplementary premium.
Currently, a 2 percent supplementary premium is imposed on each income exceeding the monthly minimum wage an insured individual earns from six sources — secondary jobs, rent, interest, stock dividends, professional practice and job bonuses that are more than four times the individual’s monthly salary.
“Some of the suggestions could be implemented in a short time, while others might have a larger impact on the public and require a more thorough assessment,” Chu said.
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