Doctor Goes On Hunger Strike Against Taiwan Health Insurance Claim System

Doctor Goes On Hunger Strike Against Taiwan Health Insurance Claim System
Photo Credit: Reuters/達志影像

What you need to know

A point system used to calculate state reimbursements to hospitals and clinics is seen as unfair by a number of practitioners.

An orthopedist at a clinic in Taiwan yesterday went on his second hunger strike this month in protest over the Health Insurance Claim System. The strike ended around noon today.

Wang Li-wei (汪立偉), an employee at the Ho Hsin Clinic in Yilan, carried out his first hunger strike on July 12 to "fight for the dignity of Taiwanese doctors" outside the National Health Insurance Bureau (NHIB) in Taipei. He was admitted into the NHIB to file his complaint and negotiate with officials. The agency promised to make public the names of the reviewing committee members in the claim system starting this October.

However, Wang's application for his payment in April was reduced by NT$190,000 (US$5,300), leading to his second hunger strike, which he launched on July 21, once again outside the NHIB. Wang said he had applied for a NT$1,300 reimbursement per patient treated, but the NIHB ended up only reimbursing him half that amount and also fined him NT$47,000.

Legislators from the New Power Party and Democratic Progressive Party visited Wang during his hunger strike to express their concerns and are negotiating with the NHIB on his behalf. According to a netizen who spread the information about Wang's hunger strike last night, Wang is already back in Yilan after his strike concluded at noon.

Doctors struggling to survive

The Health Insurance Claim System, also known as the National Health Insurance of Medical Expenses Review, was designed to prevent the abuse of medical resources.

The NHIB negotiates annually with hospitals on the total reimbursement they can apply for each year. The hospital can then apply for reimbursement using a points system, which vary depending on the type of medical treatment. Although the NHIB allocates the agreed amount of subsidy to hospitals each month, it takes the money back if the amount exceeds the total amount of the year.

In addition, if the NHIB examines the applications and believes the medical treatments are unnecessary, it can refuse to reimburse the hospital. Moreover, hospitals can be fined 100 times the original amount they applied for. Fearing being seen as providing unneccessary medical treatments, doctors tend to become more conservative when treating patients.

Chang Huan-chen (張煥禎), president of the Taiwan Community Hospital Association, says that one point in the calculation system was worth nearly NT$1 in the past, but has gone down to NT$0.7-0.8.

"How can we survive this?" Chang asks.

Wang applied for 720,000 points in March this year, but the NHIB only reimbursed him the equivalent of 430,000 points, causing a deficit of NT$300,000 for Wang's clinic.

First Editor: Olivia Yang
Second Editor: J. Michael Cole