The National Health Insurance Administration (NHIA) would continue to expand the diagnosis-related group payment system (Tw-DRGs), but would seek to minimize controversy by facilitating communication with members of the medical field to achieve a consensus, new agency Director-General Lee Po-chang (李伯璋) said.
The Tw-DRG is a National Health Insurance (NHI) payment system that pays hospitals the same predetermined fee for treating each patient in the same diagnosis-
related group (DRG), rather than paying them according to the services rendered to a patient.
It was originally scheduled to expand to 1,716 groups in March, but was later postponed due to strong opposition from the medical community, amid concern over a potential increase in the number of so-called “unwanted patients” — those with diseases that are more difficult to treat.
Lee said on Friday that past experience has shown that the Tw-DRG is a feasible system and that it is the right direction for the national health insurance system.
However, if members of the medical community still have doubts about it, the agency would facilitate communication to understand their concerns and talk about how to improve the system, he said.
The agency would not rush to expand the Tw-DRG system within two or three months, Lee said, adding that being a surgeon, he does not like to procrastinate, so he would start talks with members of the medical community as soon as possible.
Aside from setting the DRG system as a long-term goal, the agency has set a mid-term goal of reducing medical resource waste, he said.
Through education and the media, the agency hopes to let people understand how to avoid wasting drugs and other resources, improve the quality of medical treatment and promote organ donation, he said.
Lee said there are currently 6,436 people waiting for kidney transplants, with only 264 receiving one last year.
In addition, there are more than 70,000 people receiving dialysis in the nation, he said.
It costs the agency more to support a person regularly receiving dialysis than funding a kidney transplant and postoperative healthcare, so promoting organ donation is better for both patients and the insurance system, he said.
Lee also talked about the agency’s short-term goals, which include implementing a medical service hierarchy, shortening the healthcare quality gap between urban and rural areas and alleviating the workload of healthcare practitioners.
Taiwan has a good national health insurance system, Lee said, adding that he felt honored to be appointed head of the agency.
His bottom line would be to make sure that “the NHI system will not go bankrupt,” he said.
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