Thu, Dec 30, 1999 page2

• Health insurance defends multibillion-dollar deficit

  • By Erin Prelypchan / STAFF REPORTER
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  The national health insurance program's NT$20 billion deficit for 1999 -- up 500 percent from NT$4.15 billion in 1998 -- is no cause for public concern, officials said yesterday when questioned about the state of the bureau's books.

  "The public looks at our numbers and says `the national health insurance program is about to go under,' but our finances are quite normal. There's no reason for everyone to worry," said Lai Mei-shu (賴美淑), president of the Bureau of National Health Insurance.

  At a year-end press briefing yesterday, bureau officials came under fire from reporters for a variety of financial questions, including rising payments by the public for health insurance services and free health care for 921 earthquake victims.

  The bureau's vice president and chief financial officer Chu Tzer-ming (朱澤民) said the deficit was created because the program's income has remained near constant over the five years since health insurance was instituted. Expenses, however, outpaced income in March of last year and continue to climb as usage of subsidized health care services become increasingly popular, he said.

  The program's situation is not yet dire, Chu said, as the bureau ran a surplus from 1995 to 1998 which exceeds the total deficit for the past two years.

  "The national health insurance program is like a camel -- we can go for a long time without taking a drink of water," Chu said.

  But despite the official optimism, the bureau cannot afford to extend free medical care for victims of the 921 earthquake and the Oct. 22 quake in Chiayi beyond its six-month deadline, Lai said.

  "We can only extend [preferential treatment] if we have the resources," Lai said, referring to requests from residents in disaster areas to President Lee Teng-hui (李登輝) that free medical care needed to be continued past March 31.

  Currently, members of the health insurance plan who were injured or whose homes were damaged or destroyed in either earthquake receive free -- as opposed to subsidized -- health care. Approximately 320,000 people are eligible, according to the bureau.

  "Under the National Health Insurance law, [giving free medical treatment to quake victims] is not our responsibility ... but we wanted to remove economic barriers to medical care," Lai said. The Cabinet is paying for preferential treatment for quake victims, she said. Free health care for quake victims costs approximately NT$120 million per month, according to the bureau.

  When questioned about how the bureau planned to continue to sustain itself, Lai said the bureau's goal for 2000 is to rein in expenses by 8.8 percent and increase income by 3.5 percent.

  "We realize that this still leaves a gap, but we remain optimistic about the next year," Lai said.

  Some of the increased income will come from the National Welfare Lottery, she said. The bureau's income for 1999 was NT$280 billion, Chu said.

  When asked whether increased income for the bureau would translate into higher fees for health care users next year, Lai said that she could not rule out that possibility.

  "[Raising fees] has been a possibility at any time since the bureau was established," she said.

  The bureau hopes to decrease spending by discouraging unnecessary use of health care services, Chu said.

  The average number of doctors' visits per patient per year was 12.9 for the years 1995 and 1996, according to DOH statistics. For 1998, that figure jumped to 15, Chu said.
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