The Department of Health (DOH) confirmed yesterday that a proposed increase in national health insurance premiums would be implemented sometime next month, but remained evasive on the exact details of the new payment scale.
Premier Wu Den-yih (吳敦義) on Tuesday night rejected the department’s original proposal to increase premiums starting from the NT$24,000 (US$750) monthly salary bracket. Wu said the adjustment should only apply to people earning at least NT$50,000 or NT$60,000 a month and the cost differential must be capped at between NT$70 and NT$80.
Department of Health Minister Yaung Chih-liang (楊志良) would only say the department was still crunching the numbers and hopes to unveil details of the new pay scale next month.
“This will only be a minor adjustment and our target is that 75 percent of the population will be spared from the increases,” he said.
Under the current system, the premium for an employee is set at 4.55 percent of 30 percent of their registered insurance subscription (投保薪資).
The insurance subscription refers to the level at which an employer registers an employee for health insurance, and it is usually roughly equivalent to an employee’s monthly salary.
There are currently 46 levels, the highest being NT$131,700. Those whose monthly salaries exceed this amount have only NT$131,700 included in health insurance premium calculations.
For example, a worker whose insurance subscription falls in the NT$50,600 level now pays NT$691 per month in premiums.
There was speculation that the premium would increase to at least 5 percent, but still only on 30 percent of the insurance subscription level. Based on an increase to 5 percent, the same worker would have to pay NT$759, or NT$68 more each month, or NT$144 more if the rate is raised to 5.5 percent.
Bureau of National Health Insurance (BNHI) Director-General Cheng Shou-hsia (鄭首夏) said the bureau did not rule out basing the calculation on gross income, including bonuses, in the future but that would not be decided until much later, he said.
Wu said the increase would meet the condition that 75 percent of the people would remain unaffected and the extra premiums paid by the rest would “fall between dozens and hundreds of NT dollars per month.”
Saying that an adjustment plan based on those conditions would be a “reasonable” way to solve the health care system’s debt problem, Wu called on well-off people to accept it and embrace the sentiment that it is “a good thing” they can do to “help people with low and medium incomes.”
Wu made the remarks when asked about newspaper reports that he had instructed Yaung on Tuesday to spare individuals earning less than NT$50,000 per month from a premium increase.
Wu said the health department was still working on determining the salary level, or subscription level, above which the premiums will be raised, adding that it would also raise the upper ceiling for insurance subscription levels to either NT$180,000 or NT$210,000, from the current NT$131,700.
In response, Eva Teng (滕西華), spokeswoman for the National Health Insurance Civic Surveillance Alliance bashed the proposal, calling it unjust and punishment for a selected few and threatened to file an appeal to the Executive Yuan if the DOH goes ahead with the proposed increase.
The fundamental principle behind a universal health care system, Teng, said is that the cost of national insurance is shared evenly among all people regardless of age, health condition or employment.
The method of charging high-wage earners more money and giving low-wage earners free passes is unfair, Teng said.
Moreover, the new method would encourage high-wage earners to lie about their earnings by asking their employers to remunerate them in other ways, such as bonuses, she said.
Teng said the BNHI has been “crying poor” for so long but had never undertaken solid reforms to root out the real “cancer” of the system — failing medical institutions that fall below the bureau’s standards.
Rather than going after faltering hospitals, clinics or individual doctors, the bureau had only multiplied the burden on patients, she said, citing the list of unsubsidized drugs and services that she said had expanded from 30 items to 40 items in recent years.
In other news, Wu said he would step down to take responsibility if the unemployment rate does not fall below 5 percent by December, a goal recently set by President Ma Ying-jeou (馬英九).
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