The government has launched a sweeping overhaul of the national health insurance fee schedule, the first major revision since the current system was introduced in 2001. On Tuesday, the Ministry of Health and Welfare's Health Insurance Policy Deliberation Committee finalized a plan to cut fees for computed tomography (CT) and magnetic resonance imaging (MRI) scans, as well as blood and urine tests, by an average of 25% and 28%, respectively, while investing 3.6 trillion won annually in regional and essential medical care.
Under the plan, the 2.6 trillion won saved annually by lowering test fees that have been overcompensated relative to costs, plus an additional 1 trillion won, will be channeled into preferential fees for non-metropolitan regions (400 billion won) and treatment for severe and emergency cases (900 billion won).
This fee reform is an unavoidable choice to save regional and essential medical care, which faces the risk of collapse. Until now, Korea's medical system has entrenched a distorted structure in which a fee scheme that rewards more treatments and tests concentrated personnel and resources on highly profitable imaging and specimen tests, while regional and essential care deteriorated. Though belated, it is only natural to undertake selection and concentration by removing the bubble in overcompensated test fees and using those resources to give regional and essential medical care room to breathe.
Even so, parts of the medical community are mounting collective resistance driven by self-interest. The Korea Medical Association announced a large-scale rally for Friday, claiming that "the damage from the fee adjustment is being passed on to medical institutions." The association's conduct of countering measures to strengthen regional and essential medical care—directly tied to citizens' right to life—with street protests is the height of irresponsibility. Moreover, health insurance finances have already turned to a deficit this year, and the situation is so dire that the deficit is projected to reach 39.5 trillion won by 2035.
The medical community must now abandon the occupational selfishness of looking out only for its own interests. Now is the time for doctors, patients, and the government to unite in saving regional and essential medical care, which has been driven to the brink of extinction. As befits a group of professionals, the Korea Medical Association should end its street protests and join the dialogue. The government, beyond the fee reform, needs to examine whether there is more to be done to strengthen regional and essential medical care. If it poses an obstacle to securing the sustainability of health insurance finances, populist benefit expansions of low urgency, such as applying health insurance coverage to hair loss treatment, should be approached with caution. Only when limited resources are concentrated on strengthening regional and essential medical care can this fee reform succeed.
