Expats' Huge Hospital Bill Shows Taiwan's Law Needs Changing: Lawyer

An expat couple’s shock NT$1.3 million (US$41,000) hospital bill in Taiwan shows the insurance laws for newborns of foreign residents need changing, a lawyer says.

Erica Brüll-Reinhold and Bas Brüll's twin girls were born prematurely and undersize on July 12, and following almost a month of health complications and surgery the twins were ready to leave the hospital.

The couple initially paid their hospital bill under Taiwan’s National Health Insurance (NHI) policy, which gives newborns coverage via the mother’s health insurance for the first two months.

They were later told that the twins would not be covered by Brüll-Reinhold’s insurance because NHI regulations require foreign babies to stay in Taiwan for six months to be eligible for coverage.

▶ See also: "Expat Couple Shocked by US$41k Taiwan Hospital Bill”

The hospital first told the couple the babies could not be discharged until the bill was paid in full. Following negotiations, the hospital agreed to discharge the twins on Aug. 12, and gave the couple the option of paying the bill over five years.

M. Bob Kao, a Taiwanese lawyer who is currently based in London, observed yesterday that the law excluding the newborns of foreigners in Taiwan from immediate insurance coverage “makes no sense.”

“The law should be amended so newborns of foreign residents should not have to wait six months for coverage,” Kao says on his Taiwan Law Blog.

He adds that while the rules relating to immediate insurance coverage are inferred in the NHI handbook, it “does not explicitly state that newborns of foreign residents are not covered by the NHI.”

“Immediate insurance coverage of babies is only mentioned for those with Taiwanese [i.e., Republic of China] citizenship, and the text of the second passage is clear that there are no exceptions for newborns of foreign nationals,” Kao says. “There is a separate page on the NHI Administration website in Chinese stating that babies born to foreign residents in Taiwan are not eligible for NHI coverage until after the six-month waiting period, but I have been unable to find an English version of this page. So, it looks like the information is there, but it certainly isn’t user friendly.”

Brüll is from the Netherlands and Brüll-Reinhold is from the U.S. They have lived in Taiwan, working as teachers, for 10 years and five years respectively. They planned to leave Taiwan in October to raise their children closer to family, but have since applied for an extension to stay in the country until next February.

The pregnancy was considered high-risk as the twins were monochorionic-monoamniotic.

Fundraising target hit, Taiwanese respond

Erica Brüll-Reinhold says the couple has reached the US$38,000 fundraising target, “thanks to a large contribution.” She has asked the public to cease donations.

As of late afternoon, the couple had raised US$21,940, which implies a single donation of more than US$16,000 has been made.

Despite the outpour of support, some netizens in Taiwan appear to be less sympathetic.

In one Chinese-language news thread, one person asks, “Why are they still looking for donations if they both have jobs and the hospital has already agreed to a payment plan?”

Another suggests people shouldn’t “take advantage of the kindness of Taiwanese.”

“Why didn’t they have insurance from their own countries or reach an agreement with their employers? They’re earning Taiwanese money and they even want Taiwan to help them raise their children? Do they intend to become Taiwanese citizens and pay Taiwanese taxes? Why don’t their respective embassies help them?”

And another suggests, “Ordinary families’ salaries definitely aren’t as high as [the couple’s], and they probably don’t have as many job opportunities. Taiwan is definitely paying you a 'satisfactory salary' or you wouldn’t stay here, would you?”

(Updated Aug. 22, 6:00pm: Fundraising target reached).

ZiQing Low also contributed to the story.

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