Doctors threaten to lay down scalpels

With less than a month before the government enforces a fixed-rate system for seven different medical treatments, doctor groups are protesting the plan ? and the reduction in their incomes it will deliver ? by threatening to go on strike.

On Sunday, the Korean Ophthalmologists Association said in a statement that it will not do any cataract operations for a week starting July 1 as a protest of the government’s plan on enforcing the mandatory system based on a diagnosis-related group, or DRG, at nationwide hospitals and clinics. Yesterday, more doctors groups joined: obstetricians, orthopedic surgeons and otolaryngologists. The chairmen of the groups decided to hold board meetings this weekend and put the decision to a vote of their members. If the members vote yes, they will determine when and for how long they will put down their medical instruments.

The DRG system classifies patients into seven different groups based on their illnesses and disorders and fixes prices for each group of procedures. Illnesses and disorders that are subject to flat rates are cataract surgeries, tonsillectomies, appendectomies, hernia operations, hemorrhoid surgeries, hysterectomies and C-sections. The Ministry of Health and Welfare estimates treatment fees will be lowered by an average of 21 percent.

Roh Hwan-kyu, chairman of the Korean Medical Association (KMA), met with representatives of the four doctors groups yesterday to ask the obstetricians, orthopedic surgeons and the otolaryngologists to join the protest. The KMA, with 90,000 doctor members, has been demanding the government scrap the new system because it will “only lower the quality of medical treatments in Korea.”

Three KMA members who were part of the Health Insurance Policy Review Committee left the committee last month to show their disapproval of the government’s plan. The committee is made up of 24 representatives from the government as well as from the medical and labor sectors.

“The new system leads doctors to give up on maximizing the quality of treatments,” Roh said. “Under the system, doctors will use cheap medical instruments and materials and skip necessary examinations to maintain their profits.”

Yoon Chang-kyum, vice chairman of the KMA, said, “Having a fixed-rate system will be disadvantageous for many hospitals and doctors because it will not reflect surging consumer prices properly.”

Park Min-soo, an official from the Ministry of Health and Welfare, said, “It’s inevitable to introduce the DRG system to reduce the growing amount of medical fees [and slow the government’s overall spending on health insurance] and also to block doctors from overtreating their patients.”

Korea has seen a rapid increase in its health insurance expenditures because of its greying society. There have also been complaints that doctors, mainly at large general hospitals, provide unnecessary treatments to patients to boost their profits.

The Ministry of Health and Welfare official said Korea is trying to introduce a system that was adopted 10 years ago in other advanced countries like the United States and Sweden. The Organization of Economic Cooperation and Development also recommended in February that the Korean government “reward hospitals according to the appropriateness of their services rather than the number of services they deliver by adopting DRG-based financing across the entire hospitals sector.”

by Lee Eun-joo [angie@joongang.co.kr]