중앙데일리

[NOTEBOOK] Hospital Shopping and Costs Control

Mar 25,2001

How much do Koreans depend on doctors and hospitals? Recently the Health Insurance Review Agency clarified that one patient visited 19 hospitals in one day.

This review agency inspects medical fees charged by hospitals from all parts of the country. The clarification mentioned above originated from the inspection process of medical fees charged by the medical institutions in Onyang. The review agency had concluded that the hospitals might have made false claims and dispatched an inspection team to clarify the situation. But they could not find any evidence of falsification of records. Actually the patient had already passed away and in the home of the deceased there were piles of left over drugs, which implied "hospital shopping."

Whether the doctors had made false claims is not going to be discussed here. What the reporter wants to emphasize is that unwise action of patients, like hospital shopping, also contributed to the depletion of medical insurance reserves. Last year, there were 1,223 patients who visited hospitals more than 1,000 times, including the patient mentioned above.

One may wonder, did they really believed that a host of drugs would really guarantee their health? In a survey in the United States, only 35 percent of the people polled made efforts to enhance their health by exercising and improving their lifestyle. Twenty-five percent of the people surveyed were passive in managing their health and the remainder were damaging their body with excessive drinking, smoking and eating.

How does this lifestyle affect medical expenses? The drinkers, smokers and obese people drove up health insurance outlays by 30 percent. And the heavy drinkers were found to use 520,000 won ($389) more each from insurance per annum when compared with normal subscribers.

These numbers raise the question on the fairness of a system in which people who maintain their health pay the same amount of medical insurance fees as those who are destroying their bodies.

Today's medical care puts more weight on the treatment of diseases than on prevention. When hospitals treat more patients they earn more money. Also medical insurance companies do not offer benefits for their subscribers' efforts to prevent illness.

Since there are not many incentives, it is largely ignored that efforts are necessary to stabilize the finances of the medical insurance system by emphasizing the importance of early discovery of illness through regular diagnosis, preventive medicine and also programs to enhance one's health.

It cost about 70,000 won to educate a person under a self-management arthritis program, which as designed by a professor at Stanford University. But the program reduced the doctor visitation for this ailment 40 percent among patients who had participated in the program. It was determined that if this program were applied to 5 million arthritis patients, approximately 340 billion won in medical expenses would be save.

There are persuasive findings in Korea, also. Last year 212 billion won was spent on the treatment of 18,000 patients for chronic renal failure, the highest amount spent on treatment for any disease. This compared with the 270 won it costs for a urine analysis to detect chronic renal failure in its early stage.

Motivation is required for people to understand the importance of preventive medicine. The development of low cost education programs to enhance health should be funded.

Professional advice from doctors increases the rate of no smoking 20 percent above that attained by teaching materials and nicotine patches. Enhancing people's health to brake the drain on medical insurance cannot be achieved in a short period of time.

But providing a sound medical system is urgently needed because the health of a nation's citizens helps determine its economic productivity and reduces social expenses.



writer -----------------------------------------------------------------------


The writer is a deputy information and science news editor.


by Ko Jong-kwan




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