The Executive Yuan passed an amendment to the National Health Insurance Law yesterday in which premium rates will be determined based on household income, not on individual earnings, and insurance coverage for non-resident immigrants will be canceled.
In the Cabinet's last meeting before Premier Frank Hsieh (謝長廷) stepped down, the Executive Yuan agreed to the proposed amendment to help cover Taiwan's health insurance system's large financial deficits.
The proposal will be forwarded to the Legislature for review and approval.
Under the proposed revision, the new health insurance premiums will be determined based on household income, capped at the income of a four-person household.
Premiums will be set at between 3 percent and 4 percent of income, which is lower than the existing rate of 4.5 percent.
Kuomintang Legislator Yang Li-huan (楊麗環), who follows the health insurance issue closely, told The Taiwan News that double-income families and singles with high incomes will have pay higher premiums under the new scheme.
The amendment to the National Health Insurance Law, dubbed the "Second-Generation National Health Insurance," stipulates that the current classification of the insured will be narrowed down to two categories - employees who file income tax returns and their families, including office workers, active military servicemen and teachers lumped in one category and all others, including the unemployed or low income families, in the second category.
At least 20 million people are covered by the program.
In addition, the current system of classifying individuals as either "insured" and "dependents" will be scrapped, with all persons covered by national health insurance now simply referred to as "insured."
Under the proposed scheme, former beneficiaries who have emigrated to other countries and have returned to Taiwan will have to establish residency by living in the country for four months before they are eligible to rejoin the program.
The proposal also expands coverage. Medicines prescribed for patients will not be limited to those listed by the National Health Insurance Bureau, and may include new and more effective medicines at higher prices, if patients are willing to pay the difference.
Another change to the law will prohibit hospitals and medical institutions from announcing discretionary services and medicines that they provide that are not covered by insurance.
The funds required to finance the program will come from the government and from premiums paid by employers and employees according to a formula based partly on Taiwan's gross domestic product.
The central government will contribute 85 percent of the government's share of the budget, with the remaining 15 percent coming from city and county governments.
Outgoing Premier Hsieh pointed out, however, that the budget contributed by local governments should also be stipulated in the Financial Allocation Law, which has not been submitted to the Legislature for revision.
While the National Health Program, which has been in place since 1995, has been widely praised, it has also been questioned for its efficiency, quality and fairness, he said.
The outgoing premier stressed that it was necessary to reform the national health program. In order for the new program to be implemented smoothly, the government should raise sufficient funds reserved for the program, which the new law sets at NT$33 billion. Hsieh said this amount will cover medical spending for a few years.
According to existing regulations, foreign employees should provide photocopies of their work permit and residence certificate to their employers for enrollment in the program.
A foreigner who is the head of an enterprise is also eligible for the program coverage after residing in Taiwan for more than four months. Unemployed foreigners, if qualified as dependents of an insured person, may enroll under that insured person.
Unemployed foreigners, if not qualified as dependents of an insured person, should bring the residence certificate to the village (township, municipal and district) administration offices to enroll in the program.