The National Health Insurance Administration (NHIA) has announced that they will expand coverage for the Advance Care Planning (ACP) consultation fee to encourage more people to make Advance Directive (AD) decisions.
Under the Patient Right to Autonomy Act, an AD serves as an individual’s autonomous will should they fall into a coma or become otherwise unable to make decisions. However, since the act first came into effect in 2019, less than 1% of people have created an AD, in part because the requisite ACP consultation costs approximately NT$3,000 (USD$93.55).
The NHIA announced that it would expand the scope of health insurance benefits for the ACP consultation to include patients over 65 years old with major injuries and illnesses and those with multiple chronic diseases starting May 1. Consultation services will also be made available at primary care clinics. An estimated 1.8 million people will benefit from these changes.
Legislators from across the aisle weighed in on the proposed amendments. DPP legislator Lin Yueh-chin (林月琴) observed that AD promotions have stalled. KMT legislators Wang Yu-min (王育敏) and Sean Liao (廖偉翔) also raised their concerns; Wang brought up the need to prioritize patients in nursing homes and long-term care centers, while Liao pointed out that ACP consultation stipulates that a second-degree relative must accompany, precluding those who live alone.
In response, the Health Ministry’s Department of Medical Affairs Director General Liu Yueh-ping (劉越萍) said both the consultation fee and cultural beliefs deter people from creating an AD. She added that the ministry is working with the NHIA to promote the program to those over the age of 50 with the aim of reaching 40,000 people per year.