[EDITORIALS]Health Insurance Plan UnhealthyThe comprehensive measures devised last May by the government to save national health insurance costs from debacle hit snags from the beginning. The government enacted a special law for the stabilization of the costs and planned to levy additional taxes of 150 won ($0.1) per cigarette pack to procure 330 billion won during the second half of the year. But because of public opposition, it is unclear if the law will go into effect this year. As a result, loans this year are expected to increase by 300 billion won more than expected, reaching 1.5 trillion won.
The aim of the comprehensive measures drawn up by the Ministry of Health and Welfare was to augment the revenues and decrease the expenses to adjust the net deficit this year estimated to be 3.28 trillion won to 1.12 trillion won. The idea was to reach a balance by 2003 and to recover financial stability by 2006. The ministry had boasted that it could improve insurance costs by 2.5 billion won a year with its 20 short-term measures aimed at increasing revenues and reducing expenses. However, the imposition of fees by grade for medical examination and medicine according to the number of patients, which went into effec in July, has faced opposition from doctors and pharmacists. Also, it is still unclear whether the new drug-pricing system in which patients would have to bear part of the cost of medicine for drugs that exceed the standard price will go into effect as planned this month, due to a backlash from civic groups, doctors and pharmacists. Therefore, 41.5 billion won in setbacks is expected this year. Further, the ministry planned to impose premiums on the 400,000 or so people presumed to have income from business or real estate but are recipients of free insurance as dependants of workplace insurance policyholders. But the current number of people to be levied only amounts to 330,000. It is also a pity that the cut in diagnostic costs stalled at 2.3 billion won since a system was implemented at a cost of 3.3. billion won.
The measures to stabilize health insurance costs are not functioning properly chiefly because the government devised the measures without considering their viability. Seoul had held high expectations on unverifiable measures such as graded medical fees and differentiated drug-pricing systems and on the handy additional imposition of taxes on cigarettes.
The objective of the separation of doctors and pharmacists lay in preventing the overuse or misuse of drugs. But research shows that the overuse of injection drugs is still widespread. Although the prescription rate of injection drugs has diminished among small clinics, the rate still exceeds 50 percent. In university hospitals, the prescription rate increased to 21 percent from 12.3 percent before the separation. The use of antibiotics has also not diminished.
The original intention of the separation has dissipated with the government running around for measures to patch the holes in health insurance finances. This is not something that can be passed over to the next administration with stopgap measures to buy time. The government should first devise special measures to find out the income of more regional insurance policyholders than simply the present 28 percent. Among those selected for livelihood protection, about 1,500 possess more than 50 million won in financial assets, revealing the government's assessment of incomes is slipshod. The government should take the issue seriously, review all possible measures, such as the introduction of private insurance schemes and then draw up clear measures to stabilize health insurance costs.