The time-honored practice of hospitals demanding a patient’s joint guarantee for a hospital admission has reemerged as a controversial issue in the medical community.

Many local hospitals require a patient to have a joint guarantor recorded on the document of an admission agreement, in case the patient is discharged from the hospital without paying medical charges.

Hospitals do not hold rights to refuse an admission of a patient without a joint guarantor. However, civic groups and the government have begun pressuring hospitals to scrap the old practice, saying it breaches patients’ right to receive legitimate medical care and violates the Medical Service Act.

In 2014, the Fair Trade Commission revised the standard terms and conditions to disallow hospitals to require a joint guarantor for an operation agreement or an admission contract. However, hospitals still demand a joint guarantor because the amendment was not legally binding.

The continued malpractice prompted the Anti-Corruption & Civil Rights Commission (ACRC) to encourage the Ministry of Health and Welfare on Dec. 5 to make state-run hospitals voluntarily delete the section of a joint guarantor or notify that it is a matter of choice in an admission contract by March 2018, and private hospitals, by June 2018.

On Dec. 13, the ministry sent out notices regarding the ACRC’s recommendation to hospitals.

According to the ACRC’s survey on 55 state-run hospitals and 63 private general hospitals, 75 percent, or 85 hospitals, had a section of a joint guarantor in the admission contract form. Out of 34 state-run hospitals that had a joint guarantor section, 33 had joint guarantors of hospitalized patients submit their information to the hospital.

A lawmaker submitted a bill to the National Assembly to abolish the joint guarantee system for medical bills. Rep. Choi Do-ja of the opposition People’s Party proposed a “Revised Medical Service Act” on Dec. 1 to ban a forced joint guarantor in an admission contract between a medical service provider or a medical institution operator and a patient or a patient’s guardian.

The Korean Medical Association strongly opposed the proposal of the bill, saying lawmakers were trying to regulate private contracts with the law.

“There is no ground to claim that applying a joint guarantee system to the medical service industry is an unfair medical service contract. It is also difficult to find any evidence to regulate a private contract between a patient and a medical institution with the law,” the KMA said on Wednesday, demanding the revision bill’s withdrawal.

“When hospitals suffer growing losses due to unpaid medical bills without any government measure to back up the losses, medical institutions cannot help but use the joint guarantee system,” the KMA said.

Despite the joint guarantee system, hospitals still face unpaid bills and find it almost impossible to receive the unpaid charges, according to the KMA.

“Some unpaid bills lead to legal battles. This makes hospitals very difficult, financially and administratively,” the association said.

The KMA added that the government should first come up with a plan to back up the unpaid medical bills and expand the subrogation payment system, rather than regulating hospitals with the law.

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