The price for an endoscopy procedure in South Korea is a third of that in Japan and only a fourteenth of the price in the U.K. according to a recent study. While the fee for endoscope disinfection has yet to be set, the fee for an endoscopy is too low, threatening the safety of the patients.
On August 30, Dr. Cheung Dae-young, a professor of internal medicine at the Catholic University of Korea’s College of Medicine announced the results after comparing the endoscopy prices of ten countries—South Korea, Taiwan, Russia, the U.S., the U.K., Israel, India, Japan, Poland and Australia—and shared that the price set by our government was among the lowest.
According to the survey, the price of a gastroscopy procedure in South Korea was 42,360 won at hospital-level hospitals, second lowest following Poland (37,118 won). In particular, the fee for a gastroscopy in Korea was a third of that in Japan (126,877 won) and only a fourteenth of that in the U.K. public hospitals (607,381 won).
The fee for a gastroscopy released by HCA Health Care, a for-profit hospital in the U.K. was 4,151,000 won and the one released by Virginia Mason Health System, a non-profit hospital in the U.S. was 3,299,000 won.
|A Comparison of Gastroscopy Prices|
Dr. Cheung pointed out that the reason our country set the endoscopy fee so low was because of an unreasonable relative value scoring system, far from the reality of health care.
The price of an endoscope system is 21,721,408 won and a relative value score is fixed for the endoscopy scope based on the amount of 21,108,095 won, but currently related costs have increased by more than ten-fold. The system costs 300 million won and the scope costs 30 million won, according to Dr. Cheung.
"The relative value score was established in 1977 more than twenty years ago, and it fails to reflect the current changes in the medical field. The equipment depreciation is set at 713 won for the cost of a video printer to print the endoscopy image, but these days the electronic image system PACS is mainly used for printing, so this expense is useless," Dr. Cheung pointed out.
According to Cheung, when we add the converted index and the adjusted index, in reality, the price is set at a level lower than the cost analyzed by the Health Insurance Review & Assessment Service(HIRA).
In 1997, the cost for a gastroscopy was 100,066 won according to HIRA. However, when the adjusted index is multiplied to the workload of the doctor and the converted index is multiplied to costs like labor, the cost is modified to less than half the actual cost: 42,360 won.
Dr. Cheung said, "If we provide compensation that is less than the actual cost of a commodity being supplied, the commodity cannot be supplied smoothly. Since hospitals have a hard time surviving with a normal revenue structure, they are forced to cut costs, increase the overall revenue, or seek other sources of income."
"Eventually, hospitals have to cut essential medical staff and use cheap materials and equipment, and this threatens the patient's safety. Hospitals are faced with a contradiction: to be sustainable hospitals, which should be the most ethical institutions, have to operate an unethical cost system. The converted index and adjusted index that people call normal practice are the start of such irrationality," criticized Cheung.
The Korean Society for Gastrointestinal Endoscopy President Kim Yong-tae (Seoul National University College of Medicine) stressed, "The government is aware of the fact that hospitals suffer losses the more they perform endoscopies. They need to approach the issue of restoring endoscopy prices to normal levels from the aspect of safety management, which they failed."
The society's Congress Chairman Yang Chang-hun (Dongguk University Gyeongju Hospital) also said, "Currently, the cost of the endoscopy equipment has increased three-fold from a decade ago, and as an OECD member state, it is embarrassing that the price of an endoscopy procedure has failed to follow the inflation rate. Even if we can't set the fee at a level on par with advanced nations, we would be an honest country to recognize the cost of endoscopies at a level similar to that in Southeast Asia or Latin America. "
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