Several years of escalating multi-billion-dollar deficits in the national health care program prompted officials from the Bureau of National Health Insurance scheme yesterday to promise a crackdown on abuses of the system.
"People are developing an unhealthy dependence on the health care system. Some people can only relax if they have seen the doctor, had this shot, got these pills. We need to make changes," said Liu Lu-kang (
Taiwanese people visit the doctor more frequently than any other country in the world, he said, at an average of 15 visits per person per year.
Although overuse of health care resources is not illegal, patients and doctors alike have pushed use of the system to illegal limits to milk as much as possible out of the system, he said.
Hundreds of such cases have been to court in the five years since universal health insurance was instituted, he said.
Hospitals and clinics often offer gifts such as rice wine and vitamins to people who will allow their insurance cards to be stamped, even though they have not received any care, he said.
The hospital or clinic can then bill the health insurance scheme for treatment which was never given and pocket the money.
One clinic in Ilan County earlier this year offered free first-aid kits to patients whose cards were stamped for doctor's visits they never had, Liu said.
Patients themselves are also finding ways to cheat the system, Liu said.
One man, surnamed Chen, was recently discovered having forged health insurance cards so that he could avoid paying for his frequent doctors' visits.
"He hadn't even forged it very well. As soon as you looked at the cards, even from quite a distance, they looked very fake," Liu said.
Chen -- who suffers from chronic illnesses and has a history of psychiatric problems -- visited the doctor 432 times in the space of ten months last year, an average of 1.37 visits per day.
To avoid the fees that high-volume health care users have had to pay since August of last year, Chen forged cards that classified him as a lower-volume user and visited hospitals and clinics throughout southern and central Taiwan.
Department of Health director-general Chan Chi-shean (
A global budget, in which the scheme allocates a certain amount of money up front per sector, could help.
This system is already in place for dental services, and will be implemented in July for Chinese medicine, Chan said.
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