The Department of Health's (DOH)Committee on National Health Insurance yesterday demanded that the department curb unnecessary spending and make full use of other sources of revenue before considering hiking insurance premiums.
"It is crucial to ensure the government does not make a premium hike its first priority when it comes to solving the National Health Insurance's [NHI] financial woes," said Bureau of National Health Insurance Vice President Lai Chin-hsiang (賴進祥), who attended yesterday's committee meeting.
The bureau has been deep in the red for some time. According to its own statistics, it has suffered an average annual deficit of NT$17 billion. Even supplemented by its NT$4.3 billion safety reserve fund, the bureau runs about NT$1 billion short each month.
The department convened a citizen panel last Saturday to review more than 30 proposals. The panel said no to an insurance hike.
In accord with that sentiment, the committee yesterday mapped out three major directions for getting out of the red -- separating public health spending from total insurance expenditure, minimizing the abuse of medical resources and finding other possible sources of insurance income.
"We have asked the Executive Yuan for an additional NT$11 billion for the public health budget to be spent on public health maintenance, teaching in large medical centers and preventive medicine, which are now covered by the NHI," said DOH Director-General Chen Chien-jen (陳建仁).
The committee also called on the bureau to incorporate more medical history data on the health insurance IC card, saying this could help cut costs by reducing the need for repetitive exams or tests.
As for finding other sources of income, the committee approved the DOH's proposal to raise the health tax on cigarettes from NT$5 per pack to NT$10. If the tax hike is ratified by the Legislative Yuan, the bureau would get an estimated NT$7 billion per year.
"Apart from the cigarette tax, we hope to raise the ceiling for the insurance premium to get more money from rich people," Lai said. "And the Bureau of National Health Insurance should not pay the medical fee for some people. For example, troublemakers who are hurt in traffic accidents or armed conflicts should pay their own costs."
Shih Yaw-tang (石曜堂), the committee's chairperson, said the government must investigate how insurance revenue is spent and establish a mechanism to monitor the system's financial health.
"A possible premium hike is on everyone's tongue. But such a hike can only be made when it is reasonable," Shih said.
"And this depends on the government designing indicators to gauge the system's financial health and making the information public," he said.
"In the spirit of democracy, the citizens should know how bad our national health insurance system is. They have the right to know all possible solutions. And then we can talk about a insurance hike," he said.
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