Double-Billing Patients Is No Reform

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Double-Billing Patients Is No Reform

On Wednesday, Choi Sun-jung, Minister of Health and Welfare, submitted his plan for the coming year to the president. He said the ministry would look into the feasibility of requiring patients to pay the full cost of some medical treatment. Individuals would be required to make regular payments to a personal account dedicated specifically for medical fees. Treatment costs below a certain amount would be paid from this account rather than by the national medical insurance. The government says that such a system would alleviate the annual medical insurance deficit of 1 trillion won ($800 billion).

Admittedly, such a system has a positive side in that it might allow the national medical insurance to offer greater coverage of chronic ailments and the diseases of aging. Nevertheless, it amounts to making patients pay two premiums or virtual increase. We cannot understand why the government is putting forth such a plan at a time when household budgets are already strained. Isn''t this just an administrative expedient for getting the public to bear the burden of the national insurance system''s structural red ink? Even without this change, people are already paying more because of frequent raises in premiums and the newly instituted prescription system.

The proposal goes against the spirit of the national medical insurance plan, whereby insurees pay premiums based on their income but everyone is charged the same low out-of-pocket fees for a visit to the doctor. We do not know what minimum medical cost would be born by the insurers, but let''s take the simple example of someone who visits a local clinic for the first time with a cold. Under the current system, he pays 2,200 won, but under the proposed system, he would pay the entire 14,000 won a clinic normally bills in such a case. That is more than a sixfold increase and will be felt as a big burden by those with lower incomes and the elderly, who need more frequent medical treatment.

The government says that such charges can curtail unnecessary visits to hospitals or clinics by people with only very minor complaints. This is nonsense. First you force people to get a doctor''s prescription for nearly any medication they might need, and then you tell them they shouldn''t visit the doctor so often. Instead of trying to introduce some other country''s plan, the government and everyone else involved should put their heads together and come up with a way to reduce the deficit without increasing the burden on the citizenry.

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