Hospitals bank on uninsured rooms

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Hospitals bank on uninsured rooms

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“What do you mean there are no six-person hospital rooms here?” asks a 58-year-old patient with liver cirrhosis from Gangwon while he was trying to arrange a hospital room in a Seoul university hospital last week.

The man pleaded he could not use a single patient room because it was too expensive.

“All the six-person rooms are full. It’s not only you who has no choice but to use a single or double room,” says one hospital employee at a reception desk. “Everyone who comes here for hospitalization uses single or double rooms at first.”

The quarrel between the man and the worker lasted about five minutes. After the patient was told he could receive surgery in June at the earliest if he insists on staying in a room with six beds or more, the man left the hospital.

For a patient deprived of options to use a patient room covered by the National Health Insurance, which is a six-person-or-more room, one night at a hospital could cost as much as 480,000 won ($430).

One might think few would spend that much money for an uninsured hospital room.

But patients who register at university hospitals are left with no choice but to spend a few days at the higher-end hospital rooms, a single to five-person room, both of which are uninsured, as illustrated by the 58-year-old man’s case.

Fully aware of the financial benefits that could be generated by putting up patients in uninsured hospital rooms that charge patients as little as 24,000 won for the five-person room and up to 480,000 won for a single room, an increasing number of hospitals are offering patients no choice but to stay at least a few days in these expensive rooms.

A 69-year-old female patient who recently had surgery to remove a tumor in her uterus at a university hospital in northern Seoul recalled she was puzzled when a nurse asked her whether she wished for either a single or a double room.

The woman opted to use a double room, which cost her 220,000 won per day.

Illustrating patients’ worsening financial burdens due to uninsured hospital rooms, medical fees spent on staying at single to five-person rooms comprised the second-largest portion of medical fees paid by patients in 2010, according to the National Health Corporation.

In 2010, 972.3 billion won was paid for uninsured patient rooms, comprising an 11.7 percent share of the total uninsured medical payment of 8.31 trillion won that year.

Bound by regulations, the number of uninsured hospital rooms for each hospital cannot exceed 50 percent of its total rooms.

Among major university hospitals in the country, Hanyang University Medical Center in Seoul turns out to have the largest portion of uninsured rooms at 49.2 percent, or 365, out of 742 rooms.

For Seoul National University, the portion stands at 43.1 percent, providing 691 uninsured patient rooms out of 1,604 rooms in total.

To reduce the burden for patients, increasing the number of insurable six-person rooms while reducing the number of uninsurable rooms seems like a key to the solution.

But hospitals don’t like that idea.

“If policy makers shrink the number of high-quality rooms without an alternative plan [to make up for revenue loss on medical service operators], its impact on the operators will be felt considerably,” said the head of a medical center in northern Seoul, who requested anonymity.

Kim Yoon, who heads the department of health policy and management at Seoul National University College of Medicine, said in an interview with the JoongAng Ilbo that one solution to a shortage of insured hospital rooms could be “having more patient rooms that are covered by national insurance on different quality levels” and “apply a different extent of insurance coverage based on the differences in quality.”

“The reduction in medical revenue should be offset by an increase in inpatient treatment bills,” added the professor.

Shin Young-suk, vice president of the Korea Institute for Health and Social Affairs, noted “gradually extending the insurance coverage to patients who had no choice but to register for uninsured hospital rooms” will ease the growing financial burden.

By Special Reporting Team [jkkang2@joongang.co.kr]

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