Fri, Mar 11, 2005 page2

• NHI to stop paying for some drugs

  PRESCRIPTION FOR SAVINGS Non-prescription drugs such as cold and cough medicine will no longer be covered by the NHI program in a bid to reduce costs

  • By Wang Hsiao-wen / STAFF REPORTER
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  People will soon have to dig deeper into their pockets to pay for non-prescription drugs their doctors want them to take because these medicines will be excluded from the National Health Insurance (NHI) program as early as July, health officials said yesterday.

  In a bid to reduce spending and keep the universal health insurance plan afloat, the Bureau of National Health Insurance decided to stop paying for non-prescription drugs.

  Last year alone, the bureau paid NT$2.3 billion for non-prescription drugs. Although that amount only accounts for 0.6 percent of its total annual expenditures, every little bit counts, according to bureau Vice President Lee Cheng-hwa (李丞華).

  Article 39 of the National Health Insurance Law (全民健保法) states that non-prescription drugs are not to be covered by the NHI program. Yet when the NHI was set up 10 years ago, non-prescription drugs -- which had been covered under the old Labor Insurance program -- were included in a bid to win public support for the new system.

  The bureau believes ending such coverage will help reduce waste of medical resources.

  "People usually get a bag of non-prescription drugs but then leave some unused. Ending payment for non-prescription drugs could be a win-win strategy for patients and hospitals," Lee said. "If patients with minor ailments can go the pharmacist, patients can save the hospital registration fee and hospitals can save their resources for the seriously ill," he said.

  The policy has drawn a mixed response from hospitals, health reform groups and consumers.

  Some hospitals agreed that non-prescription drugs should be taken out of the prescription system.

  "Most prescription drugs are not indispensable, such as cough mixtures, or medicines for colds or gastric distress. But when they are covered by the NHI, hospital usually give more than is needed to the patients. Separation of non-prescription drugs from the NHI will ease the financial burden on hospitals," said Wu Ming-yen (吳明彥), chief executive of the Taiwan Hospitals Association.

  The Taiwan Health Reform Foundation welcomed the policy shift, but is concerned that the government may not be able to provide enough information about non-prescription drugs for the public to be fully informed.

  "It is a good thing to make people responsible for their own health. But before the government passes on some of the responsibility from doctors to individuals, the government must first ensure that ample medical knowledge and quality medical service is available at the community level," said Liu Mei-chun (劉梅君), the executive-director of the foundation.

  Liu said such medication can be improperly used if people are not well informed. The Consumers Foundation voiced the same doubt.

  "How can people discern between serious illness and minor ailments?" asked Consumer Foundation chairman Jason Lee (李鳳翱).

  Jason Lee said health authorities often convey contradictory and baffling messages on health.

  "For example, when the Bureau of National Health Insurance said that people shouldn't go to large hospitals just for common colds, the Center for Disease Control told people that they shouldn't underestimate the danger of flu, which is initally indistinguishable from a cold," he said.

  He voiced concern that people from low-income families will bear the brunt of the policy change.

  "Once non-prescription drugs are removed from the NHI, fewer poor people will visit doctors. They simply can't afford both the registration fee and extra fees for drugs," he said.

  "Unfortunately, they are often the group that may not have enough medical knowledge to buy proper medicine at the drug store. Once the policy is enforced, the poor will be the first to be left out of medical care," he said.
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