Funding for long-term care sufficient, premier says

The health budget is to include NT$6 billion in funds for new cancer medicines, with NT$2.4 billion for drugs still being trialed, but considered urgent

Funding for long-term care services would remain sufficient through 2029, despite dramatic budget increases for the programs in the past few years, Premier Chen Chien-jen (陳建仁) said yesterday, adding that the government would ensure the sustainability of the system by increasing revenue and controlling expenditures.

Chen made the remarks at the Legislative Yuan during a plenary session in response to questions from Democratic Progressive Party Legislator Liu Chien-kuo (劉建國) on whether the Long-term Care Services Development Fund would continue to be sufficient to cover all long-term care services, including new ones pledged by president-elect William Lai (賴清德).

The government has not conducted a comprehensive review of the use of the fund for seven years, Liu said.

The budget for long-term care services could potentially exceed NT$100 billion (US$3.14 billion) next year if the government subsidizes residential institutions for long-term care services and around-the-clock in-home and community care services for severely disabled people, he said.

Meanwhile, actual expenditures for long-term care services in the past three years all surpassed initial estimates, he said, citing Ministry of Health and Welfare statistics.

For long-term care services, the ministry this fiscal year has budgeted NT$43.6 billion in revenue and NT$82.8 billion in expenditures, he said, adding that the Long-term Care Services Development Fund could run a deficit in less than five years if expenditures continue to increase at the current rate.

Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) said the expenditure budget was compiled based on expected revenue, which is calculated based on tax revenue received by the Ministry of Finance.

The amount of tax revenue changes annually and tends to be underestimated, he said.

“As such, the actual revenue is usually much higher than the amount estimated in the budget. After calculating the balance last year, the current accumulated fund balance is NT$150 billion,” he said.

However, the government should find a more reliable revenue source to fund long-term care services than tax revenues, Liu said.

Revenue from levying the House and Land Transactions Income Tax might gradually decrease if the government eases measures to curb speculation in the housing market, he said.

The government has calculated costs of new long-term care services pledged by Lai in his presidential campaign, and the funding would remain sufficient to 2029, Chen said.

“We will of course diligently find ways to increase revenue for the Long-term Care Services Development Fund and carefully control the expenditure,” he said.

Costs of building long-term care service facilities would gradually decrease, as almost all necessary infrastructure is in place, Hsueh said.

Liu also asked when the NT$10 billion Fund for New Cancer Drugs is to be established, as Lai had promised to do while campaigning to be president.

Hsueh said the fund would be supported by the government budget, which would be part of the total budget allocated to fund the National Health Insurance system.

The government this year appropriated a special budget of NT$20 billion to shore up the national health insurance system, of which NT$6 billion would be used to fund the use of new cancer drugs, Hsueh said.

“About NT$2.4 billion would be for temporary payments for drugs that have not completed phase III clinical trials, but are of clinical urgency. The remaining NT$3.6 billion be used to purchase new cancer drugs,” he said.

To ensure the sustainability of the fund, a new cancer drug must proceed from the phase of temporary payment by National Health Insurance to regular payment before being part of the medications covered by it, he said.

“Having the fund does not mean all new cancer drugs would be covered by the national health insurance. Otherwise, NT$10 billion would only last a short time,” he said.