Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
Reporter Zhan Jianfu reports:
In response to the increasing number of Taiwanese citizens traveling to mainland China for kidney transplants, which has led to numerous issues regarding subsequent management and health insurance reimbursements, the Department of Health has recently proposed that dialysis patients intending to undergo kidney transplants, whether domestically or abroad, must register or report to the Organ Transplant Registry Center. Without this procedure, the National Health Insurance Administration will refuse to cover the costs of immunosuppressants and related expenses post-transplant, aiming to effectively manage and track patients who receive kidney transplants overseas.
With the number of dialysis patients in Taiwan reaching 40,000 to 50,000, the medical expenses incurred by dialysis have become a significant financial burden on the National Health Insurance. Deputy Minister of Health Chen Zai-jin recently chaired a "Chronic Kidney Failure Patient Care Conference." According to officials, attendees suggested a review of the long-term indications for hemodialysis, especially given the surge in overseas kidney transplant cases over the past two to three years, which lack effective management. They urged the Department of Health to establish a set of regulations.
Health officials acknowledge that due to the still low rate of organ donation in Taiwan, traveling to mainland China for kidney transplants has become a "shortcut" for patients. Moreover, an increasing number of intermediaries are facilitating these services across the strait, offering "package deals" for NT$500,000 to NT$600,000, allowing patients to avoid lifelong dialysis. However, since most organ donations in mainland China come from executed prisoners, the pre-surgery matching and infection control are not as stringent as in Taiwan, posing certain risks. Some patients return to Taiwan, and the National Health Insurance has to cover their subsequent medical care costs. In contrast, other uremic patients with poor economic conditions can only wait for transplants in Taiwan, which is unfair.
Therefore, Chen Zai-jin instructed the Department of Medical Affairs to consider mandatory registration and reporting measures for both domestic and overseas kidney transplants. Additionally, the National Health Insurance Administration should promptly propose supporting measures to deny reimbursement for immunosuppressants and related expenses for those who fail to register and report to the Organ Transplant Registry Center.
Liu Jian-xiang, General Manager of the National Health Insurance Administration, stated that legislators had previously requested amendments to the National Health Insurance Act to cover kidney transplants in mainland China. However, the Department of Health refused, citing medical ethics regarding organ donations from executed prisoners and the risks associated with transplants in mainland China. Regarding future kidney transplants in mainland China, patients must first complete the registration and reporting procedures; otherwise, the National Health Insurance will not cover the costs of immunosuppressants. The administration plans to revise the health insurance reimbursement regulations to classify such surgeries as "overseas medical treatment," as there may be no legal basis otherwise.
Dr. Ko Wen-je, Director of the Surgical Intensive Care Unit at National Taiwan University Hospital, noted that the current registration system of the Department of Health excludes overseas transplants. Therefore, requiring registration before obtaining transplant eligibility would ensure no cases are missed, making it easier for the government to manage. Overseas kidney transplants are akin to patients paying only the down payment, with the National Health Insurance covering the subsequent costs, effectively encouraging patients to seek transplants in mainland China.
Dr. Ko emphasized that the Department of Health should not only require registration for domestic or overseas kidney transplants but should extend this to all organ transplants. He has seen many end-stage liver cancer patients secretly travel to mainland China for liver transplants, only to relapse shortly after returning to Taiwan, effectively hastening their deaths.
Dr. Li Bo-zhang, Director of Surgery at National Cheng Kung University Hospital in Tainan, also expressed support for mandatory registration and reporting for all organ transplants, ensuring patient safety. He mentioned that mainland China is about to implement an organ transplant law strictly prohibiting organ trading, which may limit opportunities for Taiwanese patients to receive transplants in mainland China. However, this could also lead intermediaries to guide patients to smaller hospitals for kidney transplants, increasing risks. Therefore, mandatory registration and reporting would provide better protection.【2006/04/21 Min Sheng Daily】
Source: http://udn. com/ NEWS/ LIFE/ LIF2/ 3272910. shtml
Health Agency Considers: No Reimbursement for Unreported Overseas Kidney Transplants
In response to the increasing number of Taiwanese citizens traveling to mainland China for kidney transplants, which has led to numerous issues regarding subsequent management and health insurance reimbursements, the Department of Health has recently proposed that dialysis patients intending to undergo kidney transplants, whether domestically or abroad, must register or report to the Organ Transplant Registry Center. Without this procedure, the National Health Insurance Administration will refuse to cover the costs of immunosuppressants and related expenses post-transplant, aiming to effectively manage and track patients who receive kidney transplants overseas.
With the number of dialysis patients in Taiwan reaching 40,000 to 50,000, the medical expenses incurred by dialysis have become a significant financial burden on the National Health Insurance. Deputy Minister of Health Chen Zai-jin recently chaired a "Chronic Kidney Failure Patient Care Conference." According to officials, attendees suggested a review of the long-term indications for hemodialysis, especially given the surge in overseas kidney transplant cases over the past two to three years, which lack effective management. They urged the Department of Health to establish a set of regulations.
Health officials acknowledge that due to the still low rate of organ donation in Taiwan, traveling to mainland China for kidney transplants has become a "shortcut" for patients. Moreover, an increasing number of intermediaries are facilitating these services across the strait, offering "package deals" for NT$500,000 to NT$600,000, allowing patients to avoid lifelong dialysis. However, since most organ donations in mainland China come from executed prisoners, the pre-surgery matching and infection control are not as stringent as in Taiwan, posing certain risks. Some patients return to Taiwan, and the National Health Insurance has to cover their subsequent medical care costs. In contrast, other uremic patients with poor economic conditions can only wait for transplants in Taiwan, which is unfair.
Therefore, Chen Zai-jin instructed the Department of Medical Affairs to consider mandatory registration and reporting measures for both domestic and overseas kidney transplants. Additionally, the National Health Insurance Administration should promptly propose supporting measures to deny reimbursement for immunosuppressants and related expenses for those who fail to register and report to the Organ Transplant Registry Center.
Liu Jian-xiang, General Manager of the National Health Insurance Administration, stated that legislators had previously requested amendments to the National Health Insurance Act to cover kidney transplants in mainland China. However, the Department of Health refused, citing medical ethics regarding organ donations from executed prisoners and the risks associated with transplants in mainland China. Regarding future kidney transplants in mainland China, patients must first complete the registration and reporting procedures; otherwise, the National Health Insurance will not cover the costs of immunosuppressants. The administration plans to revise the health insurance reimbursement regulations to classify such surgeries as "overseas medical treatment," as there may be no legal basis otherwise.
Dr. Ko Wen-je, Director of the Surgical Intensive Care Unit at National Taiwan University Hospital, noted that the current registration system of the Department of Health excludes overseas transplants. Therefore, requiring registration before obtaining transplant eligibility would ensure no cases are missed, making it easier for the government to manage. Overseas kidney transplants are akin to patients paying only the down payment, with the National Health Insurance covering the subsequent costs, effectively encouraging patients to seek transplants in mainland China.
Dr. Ko emphasized that the Department of Health should not only require registration for domestic or overseas kidney transplants but should extend this to all organ transplants. He has seen many end-stage liver cancer patients secretly travel to mainland China for liver transplants, only to relapse shortly after returning to Taiwan, effectively hastening their deaths.
Dr. Li Bo-zhang, Director of Surgery at National Cheng Kung University Hospital in Tainan, also expressed support for mandatory registration and reporting for all organ transplants, ensuring patient safety. He mentioned that mainland China is about to implement an organ transplant law strictly prohibiting organ trading, which may limit opportunities for Taiwanese patients to receive transplants in mainland China. However, this could also lead intermediaries to guide patients to smaller hospitals for kidney transplants, increasing risks. Therefore, mandatory registration and reporting would provide better protection.【2006/04/21 Min Sheng Daily】
Source: http://udn. com/ NEWS/ LIFE/ LIF2/ 3272910. shtml