The Ministry of Health and Welfare last night said the diagnosis-related group project, nicknamed “Tw-DRG” — a National Health Insurance (NHI) payment system that has long provoked controversy, is being postponed once again and would not begin next month as scheduled.
Under the Tw-DRG system, hospitals would receive the same predetermined amount for each patient in a diagnosis-related group (DRG), rather than being paid according to the amount of medical services used to treat the patient.
Medical associations, reform groups and legislators across party lines have been urging the government to reconsider the plan ever since the Bureau of National Health Insurance announced it on March 7, 2007.
Photo: CNA
At the time, the bureau said that the new system would be introduced over a four-year period, beginning in 2008. However, on Dec. 26 that year, bureau officials said Tw-DRG was being shelved for the immediate future after protests from large hospitals.
Critics have said the system might result in “unwanted patients” because hospitals might prove unwilling to spend extra money on higher-risk patients or force more doctors and nurse to work under “sweatshop” conditions.
Ministry officials have argued that the system would reduce inefficient use of medical resources and shorten hospital stays.
The National Health Insurance Administration (NHIA) announced on Thursday last week that the Tw-DRG system would be implemented on March 1.
Democratic Progressive Party (DPP) Legislator Lin Ching-yi (林靜儀) on Monday said 50 DPP lawmakers had signed a petition asking the government to postpone the policy.
Lin and colleagues Liu Chien-kuo (劉建國), Lee Ying-yuan (李應元) and Chung Chia-pin (鍾佳濱) yesterday held a news conference to call on the government to reconsider whether the policy could affect treatment quality at hospitals.
Taipei City Wanfang Hospital physician Li Shao-jung (李紹榕) told the news conference that fully introducing the Tw-DRG system before the classification of hospital levels and a patient referral mechanism had been completed would result in more unwanted patients because those with severe illnesses would be pushed over to medical centers.
Chinese Nationalist Party (KMT) lawmakers yesterday met with ministry officials to urge that the policy be postponed so that more discussions could be held with specialists, and more opinions sought.
NHIA Director-General Huang San-kuei (黃三桂), who attended the KMT lawmakers’ meeting, said he would discuss the legislators’ concerns with Minister of Health and Welfare Chiang Been-huang (蔣丙煌).
The Taiwan Medical Association and the Taiwan Hospital Association also released a statement urging the policy not be imposed next month.
The ministry yesterday evening released a statement saying that due to the various opinions voiced recently and the introduction of a new coding system this year — which is already causing stress to medical professionals, Chiang had decided to postpone the policy.
The ministry said it would leave the decision up to the new government which is to take office on May 20.
Additional reporting by staff writer
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