Critics of the controversial second-generation health insurance system yesterday said plans to backtrack to a “1.5-generation” system to calculate insurance premiums meddled too much with social welfare policies.
Some have hailed the second-generation health plan as a fairer system that would resolve the financial troubles that have long plagued the National Health Insurance (NHI) Fund. Deliberated upon for almost a decade, the reform proposal mainly focuses on replacing the current system — which calculates premiums based on an individual’s regular salary — with a premium scheme based on household income. Under the proposal, households with the same income would pay the same premium regardless of the number of family members.
The Department of Health had suggested including other income, such as cash awards, bonuses and festival awards, as well as interest on deposits, share dividends, income from leased property and professional practice income, in premium calculations.
Income from profit-seeking activities and property trading would also be included.
However, the government is now moving toward introducing a watered-down version of the reform bill, dubbed by some as a “1.5-generation” health plan, while others have called for making only slight revisions to the current health plan.
A first version of the new health insurance plan failed to obtain approval from the legislature last week.
Rumors of such alternatives have prompted National Health Insurance Civil Surveillance Alliance spokesperson Eva Teng (滕西華) to accuse the department of “backtracking” and giving up on an opportunity to establish a fair and sustainable system of medical insurance for all.
“From past experience, we already know that the ‘1.5-generation’ health plan does not work because it would be too difficult to implement,” Teng said. “By rehashing the ‘1.5-generation’ health plan, the [department] is going backward rather than forward.”
The alliance said that the “1.5-generation” plan failed to address the root of the problem as well as blind spots when it comes to the so-called “fat cats” — individuals whose income is mainly derived from overseas income, capital gains, retirement pensions and real estate trading.
The alliance called on the -department not to give in to politics and to fight for the “right plan.”
The revised plan, which the department has refused to discuss ahead of time, will be revealed by Department of Health Minister Yaung Chih-liang (楊志良) to the Chinese Nationalist Party (KMT) caucus today. Its contents will only be made public once consensus has been obtained between the Executive Yuan and the KMT caucus.
Premier Wu Den-yih (吳敦義) said the KMT would likely hold a public hearing on the reform package after it is unveiled to the caucus.
Discussing the matter yesterday, President Ma Ying-jeou (馬英九) said the plan should emphasize the principles of fairness, quality and efficiency.
The authorities involved should exchange opinions to fine-tune the technical details of the national health insurance reform plan, especially on how premiums should be calculated, Ma said.
Although it remains unclear if the modified version Yaung is considering will preserve the household income formula, Ma said it was more important for the plan to reflect the three principles he articulated rather than to apply a specific formula.
Reports have said that Yaung plans to expand the definition of “individual salary” to include overtime, year-end bonuses and other outside incentives as part of overall income.
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