Legislators and public health researchers urged the government yesterday to establish a so-called Medical Savings Account (MSA) for people insured under the National Health Insurance scheme to replace the current outpatient services payment system (
Public health researchers told participants at a meeting yesterday at the legislature that the high usage of outpatient services in Tai-wan is one of the main factors behind huge financial losses in the National Health Insurance Bureau.
"In Taiwan, people visit their doctor 15 times a year on average, and paying for these services accounts for 68 percent of the expenses at the bureau," said Ray E. Chang (
The bureau has taken steps, including charging for prescriptions, since Aug. 1 to lower use of outpatient services.
However, researchers suggested the bureau also implement an MSA system, which they said would better meet the needs of health care reform and would not compromise quality.
Experts said that similar systems -- including MSAs in the US and Medisave in Singapore -- have been adopted by countries for more than 20 years and allow people to use the funds in their accounts, which are medical allowances offered by employers, to pay for medical services.
"In the MSA system, everyone is allotted different amounts of money according to a variety of risk factors such as age, medical history and welfare status," Chang said. "Risk adjustment (-滅I校正) works through the mechanism of equalization funds so that health plans are able to collect risk-adjusted premiums while the contribution of the insured is in accordance with their ability to pay."
KMT legislator Chang Tsai-mei (
"Once people know they would be allowed to save unspent money in their accounts for future medical expenses, they would use such funds cautiously," Tsai said.
"People would use the unspent money in their accounts in case of emergencies like the 921 quake or they could give it to their children," Tsai said.
"I think the system should be seriously considered because we don't have any specific insurance plan for long-term medical care or emergency care," said Tsai.
Some 70 legislators have signed an agreement to request an amendment to health care-related laws.
In the US, however, not all politicians and insurance executives agree that MSAs are good for patients. Critics say MSAs will separate the sick from the healthy, and will only benefit the latter.
The Consumers' Union, a US-based nonprofit organization, argues that the result turns MSAs into the antithesis of what health insurance is meant to be, which is financial protection for the sick.
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