According to the National Health Insurance Administration, in 2013, the number of people with a catastrophic illness certificate or more was 923,396, which is 3.94% of the insured population. The total expenditure on catastrophic illnesses in 2013 was $162.5 billion, which accounted for 28% of the total health expenditure of the NHI, meaning that nearly 4% of the patients with catastrophic illnesses spent 28% of the medical costs. In other words, for every $100 paid in National Health Insurance, $28 went to people with catastrophic illnesses. This is the spirit of the social solidarity and also shows that caring for the disadvantaged is the core value of the National Health Insurance.
By the end of December of 2013, the number of patients with a catastrophic illnesses certificate reached 923,396, which was an increase of 24,421 and a growth of 2.7%, compared to the figure last year. That is also an increase of 169%, compared to the figure of 343,256 patients in 1997. Meanwhile, the number of the valid certificates was 986,287, an increase of 25,022 and a growth of 2.6%, compared with the figure in 2012. That is an increase of 171.8% compared to the figure of 362,925 in 1997. Among these figures, the number of the cancer certificates was the most by 482,949, comprising 49.0% of all valid certificates. The second one was the chronic mental disease certificate, with a number of 206,330, which was 20.9% of the total.
NT$162.5 billion spent on patients with catastrophic illnesses in 2013, which was an increase of $6.7 billion, or 4.3%, compared to the figures in 2012. That is an increase of NT$41.6 billion, compared to the figure in 1997, with an increase of 290.7%. In term of the average medical cost per person per year, the hemophilia patients cost most by over NT$3.3 million, which is 131 times greater than the average cost of $25,258 per person per year. In addition, the cost of the other catastrophic illness patients such as respirator patients, dialysis patients, rare diseases and cancer patients, were respectively 29, 23, 18 and 5 times higher than the average. In term of the average premium per person by NT$19,965 in 2013, the expenditure for one hemophilia patient will cost 166 people's annual premium.
Furthermore, due to advances in technology for tests and examinations, many rare diseases have been found and included in the list of the catastrophic illnesses. In addition, the new drugs have resulted in better treatments and extending patient’s life; that also made the medical expenditure growing more. From 2003 to 2013, there were 1,181 patients with rare diseases in 2003, while average annual medical costs were over NT$58,000. In 2013, the number of patients with rare diseases has increased to 6,807 by a growth of 476.4%, and the average medical expenditure for rare diseases has increased to NT$459,000 by a growth of 679.2%. The NHI premiums paid by the people help patients with rare diseases and other disadvantaged groups obtain appropriate treatments and cares.
The purpose of issuing proofs for catastrophic illness patients is to ease their financial burden during the long-term medical treatment. The insured diagnosed with a catastrophic illness recognized by the Ministry of the Health and Welfare Ministry can apply for the catastrophic illness certificate. After the NHIA’ review, a catastrophic illness certificate will be issued. When a patient has a treatment for the catastrophic illness, his/her copayment can be exempt. The application regulation can be found on the website of the National Health Insurance Administration ([Link]), or contact the regional office of the National Health Insurance Administration near you. You may also call the NHIA by the toll-free number at 0800-030-598 for further details.