Reduce costs for patients

Patients often have to agree to stay in single, double or four-person hospital rooms when they check into hospitals. Beds in six-patient rooms or larger wards can be fully booked. But the national insurance system doesn’t reimburse for the smaller rooms, and the cost comes out of the patients’ pockets. This has been a problem for many years.

A recent study by a research team led by Korea University Professor Yoon Seok-joon, that questioned 10,000 in-patients at 1,461 hospitals across the nation, underscored the financial burden of hospitalization on patients. Of the people surveyed, 59.5 percent had to choose rooms that weren’t fully covered by insurance and 40.9 percent had to get medical services that weren’t fully covered.

Patients had to pay 603.7 billion won ($563.4 million) out of the 1.02 trillion won charged by hospitals for private rooms in a single year. They paid 538.7 billion won out of the 1.31 trillion won cost in optional medical treatments.

The basic problem is that hospitals don’t have enough rooms that are fully covered by the national insurance program. As a national average, those rooms account for 74.1 percent of all hospital rooms. But at the so-called five major hospitals in Seoul, the share amounts to only 58.9 percent.

A task force at the Ministry of Health and Welfare came up with two proposals to improve the situation. It suggested the guidelines on rooms be improved and the patient’s share of costs be upped to 40 percent from 20 percent, or to increase the share of insured rooms in hospitals to 75 percent. Both ideas can help to ease the burden on patients without much change to total medical bills.

Patients may be relieved, to some extent, of extra hospital charges by the new arrangements. Yet at the same time, more people will likely choose large hospitals in the capital to get their medical care if more insured rooms are available. Other supplementary actions must be taken such as incentives to lure patients into local hospitals, an incremental payment system tied to the hospitalization period, and a stronger partnership between local and Seoul-based hospitals. Most of all, any changes in the state-sponsored health care system must consider patients’ interests first.