Pricing plan to clear out hospitals not working

Choi, 68, suffers from diabetes. For the last decade, Choi has visited a large university hospital in Seoul every three months for consultations and treatment. The hospital gives him a prescription for three months worth of medication.

But Choi is changing his medical regimen. He will continue going to the hospital every three months, but he’s getting his prescriptions from a neighborhood medical clinic. He’ll have to see two doctors and spend more time attending to his condition - but he will save money on the medicine.

Last October, the Ministry of Health and Welfare introduced a new system of charges for medicine for patients who visit large hospitals for common, chronic diseases like diabetes and high blood pressure. They now have to pay 40 to 50 percent of the medicine cost compared to 30 percent earlier. (The rest is covered by insurance.)

At local medical clinics, patients still only pay 30 percent of the medicine cost.

The idea is to revitalize neighborhood medical clinics and to allow large hospitals to focus their energies on hospitalized patients.

The Health Ministry selected 52 diseases including gastritis, ulcers and colds for the higher prices.

But patients like Choi are making an end-run around the system by continuing to get consultations at hospitals while buying their medication from clinics.

Large hospitals say there hasn’t been a decrease in number of outpatients in the past three months.

“In fact, the number of outpatients increased by two percent in November and December last year,” said an official from a large university hospital. “There’s not even much difference in the number of patients who suffer from the 52 chosen diseases.”

A university hospital in Gangwon said it saw a 12-percent increase in number of diabetes patients from October to December last year.

Another diabetes patient surnamed Lee, 52, from Gangnam, southern Seoul continues to use a large hospital and just pays the additional amount, which added up to 76,000 won ($65) for four months.

“This hospital knows my condition the best as I’ve been coming here for a long time,” said Lee.

“Plus, I trust large hospitals more than neighborhood clinics so I’ll continue using this hospital even though I have to pay more.”

Doctors say that patients, especially diabetes patients, hesitate to switch medical facilities in case there are complications.

“Fifty percent of diabetes patients develop complications that can become very serious if not treated properly, such as having to amputate toes,” said Ahn Chul-woo, an endocrinology professor at Gangnam Severance Hospital.

“That’s why diabetes patients don’t like going to smaller clinics.”

A director of a hospital in Gyeonggi said, “Patients’ preferences towards large hospitals won’t change unless [the government] reforms the country’s whole medical care system.”

By Shin Sung-sik [sharon@joongang.co.kr]