With the breakthrough of medical technology, various new therapies, precision medicine and medical materials have been introduced, and people have more choices, but they also face a great financial burden. On August 7, 2024, the Smart Patient Leadership Academy held a Patient Leadership Forum on the feasibility of synergizing health insurance with commercial insurance, inviting experts from health insurance, commercial insurance, academia and industry to discuss and share the current situation of health insurance and commercial insurance in Taiwan, and analyze the current plans of other countries, so that opinion leaders of the patient group can better understand the direction of future medical policies.
Industry, government and academia discuss health insurance and commercial insurance to match the resources of institutions to design commodity insurance policies
In recent years, the Health Insurance Administration (NHSA) has begun to discuss with many scholars the possibility of synergizing health insurance with commercial insurance, hoping that the government will divide the scope of benefits and insurance companies will develop new insurance policies to achieve the concept of supplemental health insurance. At the same time, insurance companies can also use the data in the health insurance platform to understand the prevalence of various diseases, and judge the future effectiveness of new therapies, so as to facilitate the design of products that are more in line with the market. Zhang Wenwen, head of the underwriting team of the Central Health Insurance Administration, added that at present, the Taiwan Health Insurance Administration has begun to match some hospitals to provide information about insurance companies to facilitate actuarial policy rates.
In this regard, Professor Lu Ruifen of the Institute of Management and Department of Medical Management of the School of Management of Chang Gung University also pointed out that in fact, such a collaborative method has long been in operation in other countries. Canada has launched complementary commercial health insurance to subsidize private hospital expenses, outpatient drug costs and dental services. The Taiwan Institutes of Health Forum is currently conducting a project on “Strengthening Medical Security – Exploring the Feasibility of Synergizing Universal Health Insurance with Commercial Insurance” (Professor Lu is one of the co-conveners of the project) to develop a feasibility plan, which is expected to be reported early next year.
You Naiying, deputy general manager of the commodity department of Nanshan Life Insurance, added that for the cancers with the highest concern, the form of new cancer therapy supplement kits has recently become popular to subsidize high-cost and new treatment options, such as robotic arm surgery, post-cancer genetic testing, targeted therapy, etc. Regarding the feasibility of future implementation, Professor Huang Xiuling, founder of Modern Insurance Magazine and Modern Insurance Education Affairs Foundation, bluntly said: “Commercial insurance cannot be seamlessly integrated with health insurance”, and before the official announcement of various policies, supplementary products, one-time payment insurance or home care insurance can be used as a solution at this stage.
Experts promote the concept of “second-tier health insurance” to practice the spirit of self-responsibility with different deductibles
In addition to the feasible practice at this stage, Professor Wong also proposed the concept of “second-tier health insurance”, which originated from the compulsory automobile liability insurance on the road in 1998, which has the characteristics of universal protection, regardless of the reason, and fast payment. She suggested that the concept of compulsory car insurance could be invoked, and a layer of supplementary health insurance could be added to the original universal health insurance. The second tier of health insurance can also be added with different deductibles, and different levels of burden amounts can be selected according to different financial resources, so as to practice the spirit of partial self-responsibility. Team leader Zhang Wenwen concluded that next year, the government will invest in the “temporary payment of new cancer drugs”, and the time for the new policy to run, industry, government and academia will continue to discuss in depth how to coordinate resources from all walks of life, the combination of platforms, and whether the sick and weak bodies can be included in the protection, etc., hoping that every Taiwanese person can get the best medical resources in the future.
─ Amber Chang, Public Relations Manager, Health Communication Division, PatientsForce
