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‘Ministry to raise medical fees to compensate losses from expanded coverage’
  • By Lee Min-ju
  • Published 2017.09.11 16:33
  • Updated 2017.09.22 13:19
  • comments 0

The government will increase medical fees to make up for losses caused by expanding the insurance coverage, as part of its measure to ease resistance from the medical community to the “Moon Jae-in care.”

“We will never push for the Moon care in ways to aggravate the present situation,” said Sohn Young-rae손영래, director of the Healthcare Policy Division of the Ministry of Health and Welfare. “We will push ahead with the policy through close consultation with the medical community.”

“The government will make sufficient compensation in other areas not to allow the total revenue of hospitals declines from now, Sohn added.

“For example, the uncovered MRI market of about 800 billion won ($708 million) will shrink to 400 billion to 500 billion won if the government gives insurance benefits to the service,” he said. “For the medical community, it means a revenue loss of 300 to 400 billion won, but the government will offset it by raising fees in other areas by all means.”

“However, we have yet to decide to raise which fees, and do so through consultation with the medical community,” Sohn went on to say. “The important thing for us is to set the size of the budget at 800 billion, not 400 billion won. We will increase the medical charges of covered services instead of reducing uncovered ones.”

The seventh annual event of “Young Doctors’ Forum” is under way at COEX in southern Seoul Saturday.

However, the medical community expressed concerns that problems would occur if the government fails to reach a balance in the course of compensating losses resulting from expanded insurance coverage.

“It will be far easier said than done. The government will find it hard to maintain the overall revenue in the short term,” said Professor Park Eun-chul박은철 of Yonsei University College of Medicine연세의대. “The ministry said it would compensate the loss with higher medical fees. If the timing isn’t matched, however, the imbalance can exacerbate.

“Giving insurance benefits to all healthcare services is a groundbreaking policy, but the government should move ahead with it gradually,” Park said. “The biggest problem is there is no fundamental solution to reform health insurance system.”

Other experts agreed. “I know the previous government tried to balance the total amount after expanding insurance coverage for four serious diseases. However, the policy ended up forcing people to rush to large hospitals,” said Kim Jin-ho김진호, a director of Korean Medical Association (KMA)대한의사협회. “Currently, the primary and secondary medical institutions are in trouble because of the concentrating phenomenon, but there haven’t been any follow-up measures to rectify it. How can you believe the government it would be different?”

“The ministry said the government would solve problems from expanded coverage through the natural increase of insurance premium revenue. However, the natural revenue growth will dwindle along with the surge in elderly population,” Kim went on to say. “The increase of 2.04 percent in insurance premium would end up demanding doctors’ sacrifice. Accordingly, the Moon care can be a shackle for future physicians.”

The ministry will also revamp the screening system of Health Insurance Review & Assessment Service (HIRA)건강보험심사평가원.

“Image a doctor is doing everything all right. If he or she makes just one mistake, however, it slashes medical fees,” Sohn said. “We will change the system to assess doctors based on average performance, which means HIRA won’t do a separate assessment for doctors who comply with average standards during a specified period and will evaluate overall results.”


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