Mon. Dec 9th, 2019

Help for hemodialysis patients sought

Help is being sought for 35 patients that are currently undergoing hemodialysis treatment in Palau.

Delegate Jonathan Isechal in a letter to Dr. Victor Yano, Chairman of Palau Health Care Fund (HCF) Governing Board, a body overseeing the implementation of the national health insurance, requested HCF to amend its regulations to cover costs of treatment for patients undergoing hemodialysis including follow-up check ups.

Hemodialysis treatment helps patients with kidney problems or failed kidneys by using a machine to filter wastes, salts and fluid from the blood when kidney can no longer function.

Isechal in his letter says hemodialysis patients usually undergo treatments and medical care for their conditions for years and this cause significant financial burden on patients and their families.

“Some of the patients are unable to afford the full course of recommended medical care and must elect the treatments, checkups and procedures that are absolutely necessary, foregoing other critical treatment, “ added Isechal.

Moreover, he says, Palau Constitution mandates “free or subsidize health care” but the current law excludes costs of hemodialysis and this he says, can be expanded by regulations.

Dr. Victor Yano, HCF Chairman, in an interview said that they will look into it.  He added that it will take an actuary study to determine the best course of action.

The national health insurance law excluded hemodialysis from coverage due to high cost of treatment and its impact on the viability of the program.  For example, lifetime treatment cost for specific individual exceed normal healthy member reasonable average cost. Also average annual contribution for member is $265 whilst the daily cost of hemo is over $250 dollars making the financial impact significant.

Although hemodialysis is not covered under NHI,  HCF Administrator Ulai Teltull says it is 100% covered under the MSA.

Contributions to National Health Insurance for the last 4 years are about equal to what was paid out annually for medical claims from on island clinics, off-island referrals and the national hospital. “This year we paid out more than we collected from employer contributions,” said Dr. Yano of the current status of the insurance program.

“We also need to have some reserves in case of situations like we have now with dengue outbreak, when there is a surge in demand for medical services,” added Dr. Yano.

National health insurance program was created through national law, RPPL 8-14 as result of push for healthcare reform in 2006.  The program mandates all employed persons to contribute to a fund which consists of a private medical savings called Medical Savings Account or MSA and National Health Insurance or NHI.   MSA can be used by individuals at approved private clinics and can be returned to foreign employees when they leave the country.  NHI is used to cover inpatient services at national hospital or cover up to $35,000 of medical expenses for approved off-island medical referral service. (PR)