A New Digital Age--IC Health Cards ImplementedNationwide

A variety of new systems will come into effect with the new year, but the IC health cards, with benefits for people nationwide, are the most prominent new policy.

Using IC health cards imprinted with their photographs, people can go directly to see a doctor for treatment without providing any other identification. With an IC health card in hand, most people can see a doctor six times before updating their cards. Children can make eight visits to a doctor before renewal, while people over 70 years of age can make 12. People will be able to update their cards quickly and easily using card readers installed at over 17,000 healthcare centers and local government offices.

According to BNHI statistics, when the new system is put in place on New Year's Day, about 3% of people making healthcare visits will forget to bring their IC cards, and another 1% will have yet to obtain their IC cards. Up to 220,000 people with insurance, then-1% of the country's population-have not obtained the new cards. In response to this, the BNHI has said that people who have not obtained the new cards yet have no need to worry. Until the end of March, when people without cards visit the doctor, they should go directly to the registration counter to explain their situation and then fill out a BNHI form, after which they will be considered an insured individual and can see a doctor without dealing with red tape or being required to pay out-of-pocket for their visit. After their visit, the BNHI will get in touch with them to help them obtain the new card.

The BNHI also reminds people that the new IC health card is intended to replace the old paper health card, the children's health insurance card, the pregnancy health card, and the major injury or illness card. Because of this, expecting mothers need not use the pregnancy health card, and there is no need to bring the children's health insurance card for anything other than vaccinations. The only exception is for patients suffering from severe injuries or illnesses who still have misgivings about the release of private information related to their medical condition. When these patients seek treatment, they must not forget to use both their IC health card and their major injury or illness card.

Concerns about the release of personal information caused by the use of electronic IC health cards has been the greatest worry on people's minds, and has been the cause of objections from various human rights organizations.

The National Coalition for the Protection of Personal Information has said that violations of patients' privacy have already occurred too many times since the introduction of IC health cards. In addition, given the leak of information from the BNHI's own web site at the end of last year, how can people be certain that their own medical information will not be leaked or misused?

AIDS patients and the Taiwan Association for Victims of Occupational Injuries also worry that IC health cards might make it too easy for employers with affiliates that operate healthcare facilities to obtain all of employees' medical information, to the point that people suffering from AIDS or mental illnesses could encounter workplace discrimination or be unable to find work.

According to the original design, IC health cards have an electronic patient chart function that allows doctors to look up basic personal information, including medication allergies, heart disease, high blood pressure, and similar issues. This function would also prevent problems with obtaining and reading charts when patients switch clinics and would reduce difficulties in inspecting medical records and waste from duplicating medical tests at different clinics.

In response to citizens' concerns, however, BNHI director Chang Hung-jen explains that IC health cards currently display only a small amount of information, such as a patient's name, personal ID number, number of medical visits, the card's expiration date, and types of previous medical visits; they do not display information regarding where a patient has sought treatment, patient charts, or prescriptions. As for patient information that will be entered on IC health cards in the future, the BNHI plans to invite comment from people from all walks of life as it studies the matter. Before a consensus in society is reached, the BNHI will not lightly begin to record patient charts on the cards.

Welcoming the digital age, following the introduction of IC health cards the Ministry of Finance also plans to introduce microchip-equipped ATM cards nationwide at the end of the year. Under the new system, more comprehensive information about citizens will be stored in computerized databases in both public and private institutions. Until such time as the security of the information networks can be guaranteed, aside from convenience and speed, what other functions will digital cards provide in the future? What other types of problems will they lead to? The nationwide implementation of IC health cards will prove to be an important test.