In a surprising turn of events, the Chinese Nationalist Party (KMT)-dominated legislature yesterday failed to pass a controversial amendment to the National Health Insurance Act (全民健康保險法) after an 11th-hour intervention by the speaker.
Legislative Speaker Wang Jin-pyng (王金平), also a KMT member, surprised many by announcing on the legislative floor that a second and third reading for the majority of the items included in the second-generation healthcare bill would be delayed. He did not set a date for the review.
Wang’s move came after the legislature voted down a motion by the Democratic Progressive Party (DPP) to modify Article 1 of the bill proposed by the Executive Yuan.
PHOTO: FANG PIN-CHAO, TAIPEI TIMES
The article defines National Health Insurance (NHI) as a compulsory social insurance and stipulates that the insured are entitled to stipends in cases of illness, injury and childbirth.
The DPP’s motion included the definition, but sought to lay down a number of principles for the nation’s biggest compulsory health insurance system, saying the system must be fair, that it must apply to everyone, be affordable and maintain its integrity.
The speaker had initially resolved to put the motion for deliberation on the floor, but KMT caucus whip Lin Yi-shih (林益世) called for a direct vote instead.
PHOTO: FANG PIN-CHAO, TAIPEI TIMES
Lin immediately drew criticism from DPP lawmakers, who said he was denying the party the opportunity to have an open discussion on the legislative floor.
The plenary session was brought to a standstill until about 4pm over disagreements with the new premium scheme proposed by the Executive Yuan to aid the debt-ridden healthcare system.
Unlike the current program, which calculates premiums based on an individual’s salary, the second-generation healthcare plan would do so based on total household income.
Legislators for the most part agree on the idea of calculating premiums based on household income, but the two major parties differed on how to define the term household income.
The DPP caucus suggested the inclusion of capital gains, income abroad and retirement pensions available to civil servants and teachers in the calculation of household income, a move that was supported by some KMT lawmakers, but opposed by the Department of Health (DOH) and the Executive Yuan.
The KMT supports the DOH and the Executive Yuan’s version, which would determine the premiums for housewives and the unemployed by assuming a “virtual” monthly income of NT$17,280.
However, the DPP opposes the idea, saying the scheme does not reflect reality and would damage the interests of the economically disadvantaged.
During the KMT caucus’ meeting earlier yesterday, a number of KMT lawmakers lashed out at the Executive Yuan for failing to clarify the premium rate in the bill and accused the government of forcing them to sign a “blank check.”
“This is the most ridiculous bill I have ever had to review,” KMT Legislator Yang Li-huan (楊麗環) told Minister of Health Yaung Chih--liang (楊志良) and Vice Premier Sean Chen (陳沖) during the meeting.
KMT Legislator Lin Hung-chih (林鴻池) told reporters after the meeting that some KMT legislators were worried that “we may have to pay the price in the next legislative and presidential elections [if the bill were passed].”
KMT Legislator Lo Shu-lei (羅淑蕾) said the bill proposed by the Executive Yuan did not live up to public expectations.
The DPP caucus’ version of the reform package for the healthcare system, which it released yesterday, included capping the fixed rate of contributions at 2.7 percent.
DPP spokesperson Lin Yu-chang (林右昌) said the party opposed the version proposed by the Executive Yuan, as it introduces an assumed income — even for the unemployed — and would disproportionately increase rates for the poor.
In addition, the party said the majority of the public did not yet understand the proposed system and only think that premium rates would increase, as a recent poll conducted by the party showed.
The survey showed that about 59 percent of respondents did not believe the wealthy would be asked to pay more under the proposal.
“It’s extremely improper to have NHI reforms forcibly passed and implemented while the majority of the public does not understand its content,” Lin said.
The DPP survey showed 76.8 percent of the public did not understand the proposal, compared with the 22.3 percent who did.
Under the DPP proposal, the assumed income would be replaced by a basic flat rate per contributor, excluding underage dependents. In addition, overseas income and money obtained through retirement funds and other sources would be included in the basic calculations.
In addition, the DPP proposes that government subsidies per person should not fall beneath 40 percent for any category and the percentage paid by salaried workers should not be increased.
Fees charged by hospitals should also become more detailed and information made public, the proposal says.
Later yesterday, Premier Wu Den-yih (吳敦義) said he did not want the legislature to rush the passage of the amendment without a thorough deliberation of the various points of contention.
“No one wishes that the amendment be passed hastily when lawmakers are not able to obtain the maximum degree of consensus,” Wu told reporters, referring to the deadlock in the legislature.
Wu said he hoped lawmakers and government officials would work together to formulate a system that has the most advantages and fewest disadvantages.
Weighing in on the debate, the Consumers’ Foundation said the proposed amendment was unfair and unequally distributed the burden of contribution in a manner that puts single-person households and low-income families at a disadvantage.
Following a premium rate increase on April 1 to help alleviate the healthcare system’s deficit, the DOH has said that the proposed revised health plan would promote a “more fair” insurance system.
However, the consumer rights watchdog said the proposed plan fails to address many old problems with the health insurance system and that if the legislature rushed through passing the bill, it would cause even more serious problems in the long run.
The second-generation health plan’s “inclusion of ‘virtual income’ for members of a household that do not earn income can only be called robbery,” foundation chairperson Joann Su (蘇錦霞) said.
In a position similar to that adopted by the DPP, the foundation said that by not including capital gains, overseas income and retirement pensions in the calculation of household income, the system could not be called “fair” because it would not truly achieve the objective of requiring high earners to pay higher health insurance premiums while easing the burden of low earners.
The proposal that unemployed individuals be charged at the same rate as someone who earns a minimum monthly wage of NT$17,280 is also unfair, the foundation said.
The foundation said it was strongly opposed to the second generation health plan, which robs the poor and allow the wealthy to become even wealthier and has no consideration for the protection of consumers’ rights.
ADDITIONAL REPORTING BY SHIH HSIU-CHUAN
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