The Ministry of Health and Welfare yesterday made public 36 suggestions recently put forward by the second-generation National Health Insurance (NHI) program review team, which include allowing non-Taiwanese babies to be covered by the program upon birth, spurring criticism from civic groups.
The suggestions were tendered in April by the review team, which consists of seven specialists brought together by Minister of Health and Welfare Chiu Wen-ta (邱文達) in March last year and is headed by former minister of health Yeh Ching-chuan (葉金川).
The specialists drew up the advice after deliberating in eight plenary and 16 group meetings over the past year on the structure, insurance policy, revenue and spending of the second-generation NHI program, which took effect in January last year.
The suggestions include letting babies born to non-Taiwanese parents in the nation be covered by the NHI program upon birth, rather than six months later, per current rules; using the combined annual incomes of insured individuals to determine their eligibility for exemption from the 2 percent supplementary premium; and increasing the current NT$10 million (US$328,790) cap on the maximum amount of taxable income subject to the supplementary premium.
Currently, a 2 percent supplementary premium is imposed on each income exceeding the monthly minimum wage — NT$19,273 — that an insured individual earns from other jobs.
Earnings from five other sources — rent, interest, stock dividends, professional practice and job bonuses that are more than four times the individual’s monthly salary — would also be subject to the supplementary premium if they are higher than NT$5,000.
Other major suggestions include extending the NHI program to all residents of the nation regardless of their nationality and imposing the same premiums on them, based on the “ability-to-pay” principle.
In response, Chu Tong-kuang (曲同光), director of the ministry’s Department of Social Insurance, said the review team has advised the ministry to also include money won by chance, such as lottery rewards, and income from property sales to the list of earnings subject to the supplementary premium.
As for the inclusion of babies born to non-Taiwanese parents in the program shortly after birth, Chu said that since doing so would require legislative amendments, the ministry would consider the idea for the time being.
The ministry said that, as some of the suggestions could cause widespread effects and thus need deliberation, the proposals are to be discussed at the next stage of NHI program reform.
However, civic groups yesterday criticized the proposals.
Taiwan Healthcare Reform Foundation researcher Shen Pei-han (沈珮涵) said that even if the ministry decided to determine insured people’s eligibility for exemption from the supplementary premium based on the combined annual incomes earned from the above six sources, it would not help assuage long-running contentions that the NHI program was unfair.
“Moreover, that the ministry has repeatedly failed to give serious thought to the root causes of the program’s inequality problems constitutes severe malfeasance,” Shen said.
National Health Insurance Civic Surveillance Alliance spokesperson Eva Teng (滕西華) said some of the advice was in the earliest version of the second-generation NHI program design guidebook, criticizing the advisory report as lacking new ideas and foresight.
“Not only do the suggestions fail to meet the public’s expectation for a truly reformed NHI program, they also do not seem to stand a good chance of being carried out,” Teng said.
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