The Sanitation Committee of the Legislative Yuan held a public hearing on "The Current Situation and Prospects of the National Health Insurance System" today.

(Photo by reporter Chen Yufu)

[Reporter Chen Yufu/Taipei Report] The Legislative Yuan Sanitation Committee held a public hearing on the "Current Situation and Prospects of the National Health Insurance System" today. The report of the Accounting and Accounting Office of the Executive Yuan pointed out that since 2017, the insurance revenue and expenditure have been short, in order to avoid health insurance security. The reserve balance is lower than the provisions of the National Health Insurance Law. The Executive Yuan has approved the health insurance rate adjustment plan in 2020, and will increase the health insurance premium rate from 2021. However, the insurance revenue and expenditure still show that it cannot make ends meet.

The Accounting and General Office emphasized that the income of the health insurance fund is mainly premium income, and the expenditure is mainly insurance benefits.

Since 2017, the insurance income and expenditure have been short. In order to prevent the balance of health insurance security reserves from falling below the provisions of the National Health Insurance Law, the Executive Yuan has approved the adjustment plan of health insurance premium rates on December 31, 2020, and will increase the health insurance premium rates from 2021. (The general insurance premium rate was raised from 4.69% to 5.17%, and the supplementary insurance premium rate was raised from 1.91% to 2.11%), but the insurance income and expenditure still showed that it could not make ends meet.

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The General Office of Accounting and Accounting mentioned that as of October 2022, the insurance revenue and expenditure will be short of 56.6 billion yuan, the balance of safety reserves will be 88 billion yuan, and insurance benefits will be paid for about 1.4 months.

In order to benefit the sustainable operation of the health insurance system, the Executive Yuan has requested the Ministry of Health and Welfare to make prudent and advance financial planning for health insurance on August 5, 2022, and still asks the Ministry of Health and Welfare to conduct a comprehensive review of health insurance revenue and expenditure and financial related systems.

Zhu Yihong, chairman of the Taiwan Community Hospital Association, said that Taiwan spends more than 3 billion on new medical technology every year, but the government's annual budget for new drugs is not enough. It is recommended to pay attention to the impact of delay when introducing new drugs, which is also causing financial black holes in hospitals. The government should assume financial responsibilities and prepare a special budget for other total departments, which should be managed and controlled by the National Health Insurance Administration.

Zhu Yihong suggested that government budgets should be prepared to increase government non-health insurance expenditures and reduce financial pressure on health insurance, such as public health, preventive health care, chronic disease prevention and treatment, and cancer prevention and treatment.

Those who have already paid for health insurance will be paid by the public budget and the scope of benefits will be reduced.

Lin Hengli, deputy secretary-general of the National Federation of Physician Associations of the Republic of China, pointed out that there are obvious deficiencies in new drugs and new technologies. The replacement rate of new drugs mentioned by the National Health Insurance Administration is significantly different, and old drugs cannot replace new drugs. There is a gap of about 1.5 billion yuan. I hope the government will According to the National Health Insurance Act, the subsidy reaches 36%. Now Taiwan has fallen behind Japan and South Korea. It is hoped that the ratio of health insurance expenditure to GDP can be increased.

Li Yuchun, a professor of Master of Public Health at Yangming Jiaotong University, said that the ratio of health care expenditure to GDP is indeed lower than that of OECD countries, and hopes to increase the overall health care expenditure, at least to 7.5%.

In addition, increasing the proportion does not mean health. Whether the 810 billion yuan spent on health insurance a year is spent on cutting edge, it is even more necessary to improve the precise payment.

Xie Wenhui, executive director of the Taiwan Hospital Association, criticized that Taiwan’s health insurance has been subject to political repression and distortion for a long time. Looking forward to the future, there is no tomorrow, and everyone will decide for votes that the bigger the bowl, the more the bowl. Seeing a doctor means seeing you happy. If you are happy, you can see Pingtung from Taipei Of course, health care finances will not be good. In the future, as long as there is a decent disease, you may have to pay a huge amount of out-of-pocket expenses, and in the end it will be borne by the public.

In this regard, Minister of Health and Welfare Xue Ruiyuan responded that it is indeed time for the review of health insurance, and it has been regularly reviewed in the past, but there are not many major changes, and they are all small adjustments. Maybe it is time to review. If there is a consensus, it is very good. Will continue to communicate with the community.

Xue Ruiyuan mentioned that after he took office, he proposed three matters related to health insurance. First, part of the burden is ready to go on the road.

Second, health insurance rates need to be adjusted.

Three, amending the law.

Whether or not the total amount should be changed involves the revision of the law. The administrative agency has no preset position on the revision of the law. As long as there is enough consensus in the society, it can be pushed. This is the attitude of the Ministry of Health and Welfare.

Xue Ruiyuan also said that with regard to the possibility of commercial insurance, the President once ordered to discuss this matter, first discussed by the Ministry of Health and Welfare and the Financial Supervisory Commission, but because of the epidemic, the time is still being scheduled. Insurance help is not limited to cancer treatment.

Zhu Yihong, chairman of the Taiwan Community Hospital Association, said that Taiwan spends more than 3 billion yuan on new medical technologies every year, but the government's annual budget for new drugs is insufficient. It is recommended to pay attention to the impact of delay when introducing new drugs.

(Photo by reporter Chen Yufu)