Changes to the NHI payment

recently there has been a lot in the news regarding the proposed changes to the NHI plan. as a business owner, i get hit right in the nards every month. for myself, wife and son i pay over $5000 NT, that’s not even my employees. I know that is peanut money in western standards, but i’ve been here a while and am starting to think like that laoren in the day market.
all that i have seen in the news in regards to the NHI is in regards to increasing revenues-but little about cutting costs. being around students constantly, i see my fair share of hypocondriac(spelling?) mothers rushing their kids off to the clinic after one cough. the countless of people with sensitive noses(in chinglish it’s referred to as being allergic to changes in the weather). also the number of children that are undersized due to a crappy diet. all these minor problems puts an incredible burden on any universal health system.
i am not writing this to debate if a western system is better than the taiwan system(both are universal systems), or how much americans pay for their private insurance. i am simply writing this to support the idea of cutting costs is MAYBE a better way than trying to increase revenues as per the Taiwan model.
what i am going to write applies to people with minor illnesses such as a cough or cold. this does not in anyway apply to serious illnesses. please don’t argue that a cold can turn into a terminal illness, i don’t want to go there.

  1. implement a usage amount/make people pay more for medication(tone down the visits of the crazy grandma thinking her kid has SARS)
    capping the visits per common illness. people get a cough, flu, fever, etc. they don’t need to go every three days for a refill on meds. make them pay for extra meds if they want them. where i am from, not the best system, they give you a refill option for commom sicknesses-the result- less visits to the doctor, and you pay for the medication. too many people think its free so they take advantage. that’s a not a new concept.
  2. classify sicknesses on a tiered scale.
    most of the visits to the doctor are for common illnesses. those type of minor problems should be in a tier, adjusting billing costs accordingly.
  3. increase user fees.currently most people pay $150 at clinics and $600-$900 at hospitals. that’s fine. but repeated visits for minor problems within a certain time period should be increased. WHY? to deter people with a cough going to the doctor 4 times in 2 weeks. just like car insurance, your a good driver, your rates decrease.
  4. be more strict regarding referrals.going to the famous ‘nose and throat’ specialist for a cough/runny nose is a waste of resources. a specialist deals with serious/severe cases only. this is the one aspect of the western system that i agree with. as a teacher, i do lose my voice occasionally, i am sick of parents telling me to go to a famous hospital to see a doctor for 5 minutes so he can write up a prescription without talking to me. i go to the doctor down the street and get the same meds from him.
  5. somehow cap how many patients a doctor can see in a clinic.there are always news stories about some doctor that sees x amount of patients everyday because he is so wonderful. most of his patients are minor in terms of care. capping the quantity of visits will deter people over the long run from running to the clinic.
    in no way am i referring to serious illnesses, i am just trying to start a thread to focus on the cost side of the NHI vs. the revenue side which the gov’t seems to be so focused on changing.