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Home Editorials of Interest Taipei Times NHI system plays lottery with lives

NHI system plays lottery with lives

In his denial to the Legislative Yuan to legalize euthanasia (“Government cannot take lead in law on euthanasia: Hsueh,” April 27, page 2), I suggest Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) should come clean and admit that his ministry, through selective neglect of national health insurance, is responsible for countless assisted deaths. Denying insurance coverage for serious cancer patients is the same as pulling feeding tubes for assisted suicide.

I am referring to advanced-care cancer patients who are deprived of critically needed medicines due to the National Health Insurance policy to cut funding to counter high costs, with the excuse that the NHI “can’t cover everybody.”

By failing to cover the seriously ill, is this not de facto assisted suicide? Whatever happened to the ministry’s slogan of Health for All?

As a cancer patient and a Taiwanese citizen with lymphoma, I am currently deprived of all insurance funding for my essential medication (Opdivo), for which there is no known substitute. That means that every fortnight, I have to pay out of pocket more than NT$48,000 for an injection, and that comes to nearly NT$100,000 each month.

Last year, it was shocking to learn from my oncologist at Taipei Medical University that tens of thousands of people are like me. Many are bankrupt or facing it, or just scrapping by covering costs. Many who cannot get their medicine without assistance give up and wait, likely with NHI “life-extending care,” for certain death by cancer without their vital medication.

Hsueh, as a lawyer, likely knows that late-term cancer patients make easy targets. They are elderly, distracted by illness and depression, lack resources, are often shut in and lack contact — and are well conditioned not to question bureaucratic decisions that will end their lives. Is this not the moment for all medical staff and officials to rally to the Hippocratic Oath, stand up and do their utmost for vulnerable patients? Was this not the vision of health insurance?

Last year, in the first term of my cancer, my doctor told me that I was “lucky,” as there are only limited cancer patients covered through a type of “lottery system.” Apparently, that lottery selects who gets covered while the others get bumped. This year, my coverage term ran out and that cancer lottery went against me, and I have joined the many Taiwanese in an isolated journey without end.

Curtis Smith is founder of the Union of TAITRA Workers.

Source: Taipei Times - Editorials 2023/05/09

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