Paradigm shift in medicine

The Korean Medical Association (KMA), which has planned a general strike for March, has begun working on a set of counter-proposals to the government’s deregulation measures. The government expressed its intent to talk out the differences with the KMA, which decided on a collective walkout to protest new measures extending telemedicine services and allowing hospitals to establish profit-seeking businesses. The KMA’s emergency committee will have to come up with reasonable ideas that consider the public interest.

Financial troubles in clinics and complaints about the government’s strict universal insurance policy are the underlying reasons why doctors are resorting to such extreme actions. Many of the clinics in town are faring poorly. According to the National Health Insurance Service’s audit team, 1,625 clinics closed in 2012, up more than 9 percent in 2009. Other data from the state insurance operator showed that clinics accounted for 21.9 percent of 35 trillion won ($32 billion) in medical fees covered by the public insurance policy in 2012, down from 27.3 percent in 2004.

A loss of patients to large hospitals and a medical pricing system that fails to compensate for clinical operations may be some of the reasons behind their financial troubles. The Health and Welfare Ministry admits that the medical pricing system is unfavorable for clinics, but it is nevertheless against individual practitioners running medical services beyond the public insurance coverage. The KMA argues that patients are charged with uncovered medical services and unnecessary examinations because of low pricing in public medical services.

Private clinics and doctors also complain of rigid price assessments by the National Health Insurance Service. Audits on medical fees aim to rein in the sharp increases in medical bills from excessive exams and treatments. But doctors protest that the state’s control over medical fees interferes with and undermines the professional judgment of physicians.

The government and the physician group have been arguing over their differences without attempting to discuss the matter. They should use the momentum to discuss the overall problems in Korea’s health care system and build a new era in the Korean medical industry. The government-KMA council must come up with new guidelines for pricing on insurance coverage and evaluation, and seek ways for clinics and hospitals to survive. Patient and civilian groups should also be invited to the discussions so that representatives can address their complaints on the matter and prevent medical fees from climbing even higher.