[VIEWPOINT]Emergency Care for Medical Insurance

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[VIEWPOINT]Emergency Care for Medical Insurance

It has been one year since our national medical insurance body changed its name from "medical insurance" to "health insurance" and made a new start.

This anniversary should be a time for congratulations and encouragement, but it is marred by the evident problems gripping the system.

In fact, health insurance is on the verge of crisis, and not only because of the depletion of the health insurance system's financial resources that every Korean knows about. The real crisis is that the very foundations of the system are wobbling.

Of primary concern is that people are losing confidence in health insurance. Koreans see that they are getting nothing in return for growing premiums. Newspaper reports of people flocking to subscribe to private medical insurance companies well illustrates the issue.

The main point of public insurance is that the public pools money so that healthy people are secure and sick people are cared for.

That people are now feeling that they must provide on their own for possible disasters indicates that this objective is not being fulfilled.

The main reason people are rushing to private medical insurance is that they feel they cannot rely on health insurance managers and health insurance itself.

The fact that Korean society does not appear to have the capacity to reform a health insurance system in the red is another blow.

No one is gullible enough to believe that the system's financial crisis can be solved under government guidance alone.

Many experts in the area are worried that the financial problems of the health insurance are chronic. That indicates that a complete overhaul of the system is inevitable.

A big obstacle toward working out reforms is that nobody concerned in the matter wants to look objectively and specifically at the process, because the results could impinge on their interests.

If people on all sides of the issue do not begin to work together towards a common objective of structural reform, the crisis will continue.

People should seek measures to convert this crisis into opportunity. Both the government and public must take new roles.

Most of all, the health insurance system must win back public confidence. People buy health insurance and make insurance arrangements though the National Health Insurance Corporation. This corporation is like the advance infantry of health insurance. This corporation has the primary responsibility for regaining the confidence of the people.

The shortcut to this is for the health insurance corporation to convert itself from an administrative organization to a service organization.

What citizens really want from their insurance company is not just for it to take money from them or confirm that they have a right to insurance. Every person who subscribes to medical insurance delegates the responsibility of making health care payments to their insurance corporation.

The National Health Insurance Corporation is obliged to minimize subscribers' inconvenience and answer subscribers' questions.

Most medical insurance subscribers do not have much knowledge or information about the variety of medical services provided by various medical institutions. Presenting subscribers with the friendly faces of well-informed advisors from the public health insurance company will be crucial to rebuilding public confidence.

The government's role is also important. It must exert strong leadership in the structural reform of medical insurance.

It must take measures which will force conflicting interest groups to participate and cooperate in the reforms.

The government must be future-oriented with clear objectives and induce the conflicting interest groups to discuss and resolve the problems. The government must also be aware that time is short.

The new framework for insurance must be provided in two or three years. Various systematic changes and new policy measures should be presented, always with a specific objective in view.

The current cacophony of the dissonant voices of patients, medical institutions, medical workers, medical corporations, government and politicians should be merged into a harmonious new chorus.

The success of the Kim Dae-jung administration will be judged in whether it has built a sustainable health insurance structure.

It is true that many times in the history of Korea, problems have been left unresolved until crisis has come near. It is deplorable. And the crisis in health insurance is already imminent. To convert this crisis into opportunity the government - including the national insurer - and insurance holders must assume new roles and a new approach.

A society which cannot provide for the health of its people is a primitive one.

All parties in this issue must shed their self-interested attitude just for a while and concentrate their efforts on overcoming the crisis of health insurance.


The writer is a professor of health management at Seoul National University.

by Kim Chang-yup

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