Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
【China Times, Zhu Zhenkai / Taipei Report】2009.03.17
Taiwan's annual National Health Insurance (NHI) expenditure of NT$460 billion is entirely decided by the 27 members of the "NHI Expenditure Allocation Committee" (Expenditure Committee), equivalent to each member controlling NT$17 billion. However, the committee's allocation meetings are not open to the public, and "payer representatives" even include pharmaceutical company owners. The Taiwan Healthcare Reform Foundation (THRF) strongly criticized this as a "black-box agency" and filed a petition with the Control Yuan yesterday.
The amount of NHI fees to be spent each year is determined through negotiations by the Expenditure Committee in the previous year. Every decision made by the committee directly affects how much the public must pay for NHI, wielding enormous influence.
THRF CEO Liu Mei-chun pointed out that Taiwan's NHI budget totals NT$460 billion, yet the Expenditure Committee has only 27 representatives, meaning each member controls an average of NT$17 billion—equivalent to the influence of a legislator over the government's total budget.
Liu Mei-chun stated that what’s alarming is that the negotiation meetings of these 27 members lack transparency and openness. For years, the Legislative Yuan’s Budget Center has criticized the committee as a "black-box agency not approved by the Legislative Yuan through three readings." The Legislative Yuan, once dubbed the "backroom congress," has long since implemented public transcripts of speeches, and even cross-party negotiations are now open. The Expenditure Committee should also provide transparent mechanisms for public oversight.
THRF Deputy CEO Liu Shu-chiung further noted that while the committee’s membership is divided equally among government, payer, and healthcare group representatives, appearing balanced on the surface, investigations into the members’ backgrounds revealed that among the payer representatives, one is Huang Ming-ho, president of the Show Chwan Healthcare System, and another is Tseng Yi-ching, a pharmaceutical company board member. This blatantly disregards conflict-of-interest principles, effectively increasing healthcare group representation to 40%, yet the Department of Health still approved their appointments.
Liu Shu-chiung cited the highly controversial "drug price survey" case as an example. Investigations found a staggering NT$15 billion surplus from drug procurement price differences, which, by regulation, should have been entirely allocated as a "safety reserve" to benefit the public. However, after discussions, the Expenditure Committee allocated NT$12 billion to the medical sector, and the remaining NT$3 billion flowed back to the sector the following year—effectively diverting the entire NT$15 billion drug price black hole into the medical industry.
Liu Mei-chun emphasized that the Expenditure Committee should follow the Legislative Yuan’s model by keeping detailed meeting records and publishing them online within a week. All agendas should be announced one week before meetings to allow the public to voice opinions in advance, preventing controversial issues from being smuggled in as last-minute proposals.
Control Yuan member Huang Huang-hsiung, who accepted the petition, stated that since NHI is mandatory, the lack of transparency in decision-making is indeed unreasonable. Administrative agencies should amend relevant regulations, and the Control Yuan will also launch an investigation.
Source: http://health. chinatimes. com/ contents. aspx? cid=5,63& id=5261
How the $460 Billion Health Insurance Fund is Spent Remains Undisclosed
Taiwan's annual National Health Insurance (NHI) expenditure of NT$460 billion is entirely decided by the 27 members of the "NHI Expenditure Allocation Committee" (Expenditure Committee), equivalent to each member controlling NT$17 billion. However, the committee's allocation meetings are not open to the public, and "payer representatives" even include pharmaceutical company owners. The Taiwan Healthcare Reform Foundation (THRF) strongly criticized this as a "black-box agency" and filed a petition with the Control Yuan yesterday.
The amount of NHI fees to be spent each year is determined through negotiations by the Expenditure Committee in the previous year. Every decision made by the committee directly affects how much the public must pay for NHI, wielding enormous influence.
THRF CEO Liu Mei-chun pointed out that Taiwan's NHI budget totals NT$460 billion, yet the Expenditure Committee has only 27 representatives, meaning each member controls an average of NT$17 billion—equivalent to the influence of a legislator over the government's total budget.
Liu Mei-chun stated that what’s alarming is that the negotiation meetings of these 27 members lack transparency and openness. For years, the Legislative Yuan’s Budget Center has criticized the committee as a "black-box agency not approved by the Legislative Yuan through three readings." The Legislative Yuan, once dubbed the "backroom congress," has long since implemented public transcripts of speeches, and even cross-party negotiations are now open. The Expenditure Committee should also provide transparent mechanisms for public oversight.
THRF Deputy CEO Liu Shu-chiung further noted that while the committee’s membership is divided equally among government, payer, and healthcare group representatives, appearing balanced on the surface, investigations into the members’ backgrounds revealed that among the payer representatives, one is Huang Ming-ho, president of the Show Chwan Healthcare System, and another is Tseng Yi-ching, a pharmaceutical company board member. This blatantly disregards conflict-of-interest principles, effectively increasing healthcare group representation to 40%, yet the Department of Health still approved their appointments.
Liu Shu-chiung cited the highly controversial "drug price survey" case as an example. Investigations found a staggering NT$15 billion surplus from drug procurement price differences, which, by regulation, should have been entirely allocated as a "safety reserve" to benefit the public. However, after discussions, the Expenditure Committee allocated NT$12 billion to the medical sector, and the remaining NT$3 billion flowed back to the sector the following year—effectively diverting the entire NT$15 billion drug price black hole into the medical industry.
Liu Mei-chun emphasized that the Expenditure Committee should follow the Legislative Yuan’s model by keeping detailed meeting records and publishing them online within a week. All agendas should be announced one week before meetings to allow the public to voice opinions in advance, preventing controversial issues from being smuggled in as last-minute proposals.
Control Yuan member Huang Huang-hsiung, who accepted the petition, stated that since NHI is mandatory, the lack of transparency in decision-making is indeed unreasonable. Administrative agencies should amend relevant regulations, and the Control Yuan will also launch an investigation.
Source: http://health. chinatimes. com/ contents. aspx? cid=5,63& id=5261