Advance care planning consultation fees might be covered by the National Health Insurance (NHI) system starting next year, Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) said yesterday.
Hsueh made the remark during his opening speech at the Taiwan Academy of Hospice Palliative Medicine’s general assembly and academic seminar in Taipei.
Advance care planning refers to making decisions about healthcare preferences before becoming seriously ill, and sometimes involves creating a legal document to make sure that those wishes are carried out.
Photo: Chu Pei-hsiung, Taipei Times
To ensure that terminally ill patients receive dignified care, whether treated at home, a residential care facility or a hospital, the Ministry of Health and Welfare is looking at implementing three strategies, Hsueh said.
First, it is to discuss a plan to increase NHI benefits for at-home hospice and palliative medical teams, he said.
Second, the ministry encourages people to sign an advance directive form and a hospice and palliative care consent form, in line with the Patient Right to Autonomy Act (病人自主權利法) and the Hospice Palliative Medical Care Act (安寧緩和醫療條例), he said.
If one out of every 10 terminally ill people signed such forms, they would spend one day less in a hospital, which can sometimes save tens of thousands of dollars in medical expenses, he added.
However, a consultation service is usually required for signing an advance directive, which is about NT$2,000 to NT$3,000 (US$62.07 to US$93.11) per hour, Hsueh said, adding that the cost might hinder people’s willingness to complete the forms, Hsueh said.
Therefore, the ministry aims to include the fee for eligible people in the NHI coverage, but the NHI Committee must first approve it, he said, adding that the ministry would ask the NHI Administration to look at implementing the idea so it takes effect next year.
The third strategy is for hospice and palliative care to be included in the long-term care system, through the home-based primary healthcare program for people with disabilities, he said.
Hopefully, through the trust built between family physicians and at-home patients with disabilities, the patients would be willing to sign the advance directive form and the hospice and palliative care consent form, he added.
Hsueh said that as there are discussions about legalizing euthanasia, the ministry must review its hospice and palliative care policies and consider whether it has done enough to ensure that patients receive adequate healthcare.
The issue of euthanasia is also a challenge for healthcare workers, as it clashes with their core medical values of saving lives, he said, adding that the World Medical Association also opposes physicians taking part in euthanasia.
In other news, as the Cabinet approved a proposal to increase the monthly minimum wage to NT$27,470 next year, health insurance premiums for some people would also increase, the ministry said.
It said that its latest estimate showed that that the policy would affect the health insurance premiums of about 8.18 million people next year, with an average increase of NT$20 per month per person.
The NHI is expected to receive an increase of NT$5.2 billion from the increased health insurance premiums, it said.
Additional reporting by Lin Hui-chin
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