Tue, Aug 10, 2004 page2

• New health policy could cut needed care

  SECOND OPINION The Bureau of National Health Insurance is trying to cut health care costs by limiting reimbursements, and some experts say patient health is at risk

  • By Wang Hsiao-wen / STAFF REPORTER
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  Although the Bureau of National Health Insurance (BNHI) plans to provide universal health coverage for the nation's people, its newly launched budget policy might instead harm some patients' access to medical care, health experts cautioned during a conference on public health policy in Taipei yesterday.

  "Since the beginning of last month, we have heard about patients getting rejected or paying extra fees for medication," said Wang Chen-yun (王貞云), the director-general of the Taiwan Health Reform Foundation.

  "Earlier on, we received complaints from patients, who said they were turned down by the Taichung Veterans General Hospital and China Medical University Hospital," Wang said.

  Launched last month, the policy requires that each hospital receive a fixed budgetary allotment, regardless of how many patients they treat.

  Since then, hospital managers have been racking their brains for new ways to cut down on medical expenses.

  One method they have adopted is to take fewer patients. From the hospitals' point of view, however, limiting the number of patients they admit does not necessarily mean depriving patients of their rights. On the contrary, hospital representatives said, this allows hospitals to minimize resource waste and save manpower and wards for those truly in need.

  "Our statistics show that, on average, each person goes to see a doctor 14 times a year, a relatively high figure compared to the average of 4 to 7 times a year in Western countries," said Chuang Yi-chou (莊逸舟), chief executive of the Taiwan Hospital Alliance's Committee for Global Budget Implementation.

  Hospital representatives called on the public to change their habits when it comes to seeking medical treatment.

  "When you have a cold or a stomach ache, it is not necessary to go to a hospital. Hospitals are designed to take care of patients with severe or rare diseases and deal with emergencies," Chuang said.

  Others contended that hospitals, not the public, should take responsibility of the abuse of medical resources.

  "What do you expect patients to do?" asked Chiu Ching-hwa (邱清華), the Consumer's Foundation's honorary president. "Hospitals used to encourage them to come to their embrace when there was no quota limit. Patients were advised to take X-rays frequently, to undergo unnecessary surgery and to seek a doctor's opinion whenever they had a headache or sore throat. Lacking professional medical knowledge, they can only trust their doctors,"

  According to Chiu, until the BNHI can integrate a family doctor system into the healthcare system, a closed door at a hospital often means a hope extinguished. Patients with rare diseases, in particular, bear the brunt of the new budget policy's shortcomings.

  "When hospitals tighten their expenses, patients with rare diseases are the first to get kicked out. Some patients cannot obtain life-sustaining medicine, because hospitals stop importing the necessary drugs from abroad," said Yang Yung-hsiang (楊永祥), the deputy chief executive of the Taiwan Foundation for Rare Diseases.

  Yang also said that rejected patients with rare diseases often suffer in silence. They cannot disclose which hospitals or doctors refused them for fear of losing medical care.

  "Whenever patients file complaints against hospitals for discrimination, they risk losing their sole source of medical help. If we name the hospital, these patients can never again go to the same hospital to ask for medication that their lives depend on," Yang told the Taipei Times.

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