Changes Made to NHI Fees Portion Borne by Public 健保部分負擔改革 藥品.慢箋入分級醫療

Changes are underway for the national health insurance fees borne by the public. They will be discussed during a National Health Insurance Committee meeting on Feb. 25.


People wait to pick up their prescriptions at a hospital. Many people in Taiwan love visiting hospitals. They seek treatment for all types of ailments, no matter how big or small. The Ministry of Health and Welfare is hoping to put an end to this type of behavior by adjusting the portion of national health insurance fees borne by the public. For example, people will now need to pay for some chronic illness medications that were previously covered by health insurance. As for medical tests, those who exceed their set quota will have to pay more.

Shang Tung-fu, Director, Department of Social Insurance, MOHW: “For emergency treatment, we hope to lower the portion paid by those who really need it. We hope that people will go to outpatient services for mild conditions instead of emergency treatment. If they seek emergency treatment, then they will have to pay more.”

Hung Tzu-jen, Dep. Superintendent, Shin Kong Memorial Hospital: “The National Health Insurance program can save NT$25 billion if every person seeks medical treatment one fewer times.”

The MOHW says the medication fee portion borne by the public is currently based on a quota, and the maximum amount collected is set at NT$200. Test fees are not collected. It hopes to rationalize both types of fees in the future. Civic groups say these changes will create economic barriers for people needing medical treatment.

Lin Ya-hui, CEO, Taiwan Healthcare Reform Foundation: “Are these punishments in disguise? It will be hard to guarantee that they won't create economic barriers for people who really need medical treatment.”

The MOHW said it is already using cloud medical records to prevent duplicate tests and prescriptions, hoping this will deter people from seeking unnecessary medical treatment. Fees will be waived for people with severe disabilities and the economically disadvantaged. The changes will be discussed during a National Health Insurance Committee meeting on Feb. 25 and the objective is to implement them before the end of the year.

 

 

 


醫院大廳掛號領藥總是滿滿人潮,為了遏止部分民眾愛逛醫院,不論大病小病都往醫院跑的就醫習慣,衛福部將調整部分負擔,例如一般藥品、慢箋藥品的部分負擔,將融入分級醫療進行調整。另外,檢驗部分若超過一定額度,將依比率向民眾收取費用。

衛福部社保司長商東福表示:「在急診來講,我們希望說真正去就醫的,他反而可以調降(部分負擔)。如果是屬於比較輕症的,我們希望他去門診或者怎樣,他反而這一部分可能調高。

新光醫院副院長洪子仁指出:「每減少一次平均次數就醫的話,大概健保的支出就可以少250億。」

衛福部表示,現行藥品部分負擔是採取「定額收取」,民眾最高只需負擔200元,檢查檢驗費則是不予收取,未來希望藥品及檢查檢驗費用都要更合理化,不過有醫改團體擔心,會造成民眾就醫的經濟障礙。

醫改會執行長林雅惠表示:「會不會變相懲罰到去生病的這樣的人,也很難保證說,它不會造成民眾就醫的經濟障礙。」

衛福部強調,已運用雲端藥歷減少重複檢查及用藥,藉此減少民眾不必要的就醫。此外,對於重度、極重度身障者及中低收入戶等經濟弱勢者,則是免除部分負擔,不過相關方案,預計下週五由健保會開會討論,目標希望今年能夠上路。
 

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