In a rare and historic consensus, the National Health Insurance Administration, Ministry of Health and Welfare (NHIA, MOHW) reached agreement on the total NHI budget for 2026. On the 24th, the NHIA held negotiations for the 115th fiscal year’s total budget, covering the five major sectors: hospitals, Western primary care, traditional Chinese medicine, dentistry, and dialysis. All five sectors ultimately agreed on a total budget growth rate of 5.5%, reaching NT$988.31 billion. This marks the first time since 2002 that all parties reached full consensus.

However, representatives of Western primary care clinics voiced concerns that funding for chronic disease and metabolic syndrome prevention programs remains insufficient. They urged the government to use public budget allocations to fill the gap, warning that underfunding could undermine the frontline of primary care.

NHI total budget negotiations are held annually in September to discuss budget allocation among the five major sectors. In past years, disagreements over growth rates often prevented consensus, requiring the Ministry of Health and Welfare to intervene with a compromise “dual proposal.” This year’s meeting lasted from 9:30 a.m. to nearly 10:00 p.m., at one point stalling due to disagreements over the Western primary care budget.

Kaohsiung County Medical Association President Wang Hong-Yu noted that it was only around 9:30 p.m., after Taiwan Medical Association newly elected Chairman Kuan-Cheng Chang consulted all parties and conceded part of the budget, that an agreement with NHIA committee members was reached. Despite the agreement, Wang expressed disappointment with the outcome.

Wang emphasized that primary care clinics are the first line in chronic disease prevention, covering initiatives such as Helicobacter pylori eradication for gastric cancer, expanded use of cholesterol-lowering and oral hypoglycemic medications, and chronic kidney disease prevention. Much of the originally planned funding was cut. For example:

• Gastric cancer eradication was initially estimated at NT$1.2 billion but approved for only NT$300 million.
  
• Programs to delay dialysis in chronic kidney disease patients were projected at NT$500–700 million but only NT$353 million was allocated.
  
• The metabolic syndrome prevention program, originally budgeted at NT$887 million, received no funding.
  

Wang stressed that metabolic syndrome prevention is a key component of President Lai Ching-Te’s “Healthy Taiwan 888” policy. Without adequate resources, implementation will be difficult. He called on the National Health Agency to allocate funds for patient enrollment, follow-up, and evaluation, ensuring that primary care clinics have the resources to fully engage in chronic disease prevention and promote nationwide health.

Resource: 健保總額23年來首度「全壘打」 基層醫盼慢病防治資源補強