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Sharp hike in NHI spending may cause premium rise by 2025: Negotiators

12/05/2023 06:08 PM
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CNA photo Dec. 3, 2023
CNA photo Dec. 3, 2023

Taipei, Dec. 5 (CNA) Taiwanese could face higher health insurance premiums by 2025, a year ahead of schedule, after the government decided to increase national health insurance spending by the maximum amount negotiated earlier this year, some negotiators argued Sunday.

The government decided on Nov. 30 to increase the NHI budget for 2024 by 4.7 percent to NT$875.5 billion (US$28 billion) after it tentatively set a rate of growth of between 2.621 and 4.7 percent following negotiations in July between medical service providers and fee payers (consumers).

It was the first time in eight years that the government agreed to use the high end of the range to determine the increase in the annual budget, which covers all reimbursements to medical service providers for the cost of care they provide under the insurance system.

The 4.7 percent budget increase was mainly aimed at supporting new medical technologies, bolstering critical care for children, and improving nursing capacity, said National Health Insurance Administration (NHIA) Director-General Shih Chung-liang (石崇良).

The higher spending will not help the finances of the NHI system, which has operated at a deficit in recent years, especially after the government decided to keep the premium rate of 5.17 percent unchanged in 2024.

Insurance premiums are the main source of financing for the NHI's medical expenditures, but instead of increasing premiums, the Cabinet has decided to create a special budget -- an additional budget approved separately outside the central government budget -- of NT$24 billion to fill the gap.

That has led to frustration among some of the negotiators.

They argued that the increase in reimbursements was not sustainable and would quickly exhaust the NHI reserve, which should equal at least one month of medical expenditures and is designed to keep the NHI system solvent when facing unanticipated deficits.

Lee Yung-cheng (李永振), a consumer representative on the NHI budget negotiation committee, said at a press conference Sunday that patients will have to pay higher NHI premiums a year ahead of schedule.

He said the NHIA estimated that health insurance premiums would have to be increased in 2026, but because of the improper drawing-down of the NHI reserve, they would have to be increased in 2025 by a significant amount to nearly 6 percent, increasing patients' burden.

"Can the people afford it?" Lee asked.

Han Hsing-wen (韓幸紋), an accounting professor and NHI committee member, found fault with the process by which the decision was made.

Han said the 4.7 percent increase in the NHI budget was announced directly by the NHIA without having been discussed by the committee, which not only broke the law but also set a bad precedent that would hurt the trust between patients and medical service providers.

But Hung Tzu-jen (洪子仁), chairman of the Taiwan College of Healthcare Executives and deputy superintendent of Taipei's Hsin Kong Wu Ho Su Memorial Hospital, expressed his support for the NHIA.

The NHI budget has always been insufficient, he said, stressing that the increased reimbursement budget was necessary to introduce new drugs or technologies and increase the salaries of medical personnel.

(By Chen Chieh-ling and Lee Hsin-Yin)

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