Health care 'freeloaders' targeted by Yoon in insurance reform push

Economy

Published: 13 Dec. 2022, 15:55 Updated: 13 Dec. 2022, 19:14

Health care 'freeloaders' targeted by Yoon in insurance reform push

President Yoon Suk-yeol starts a cabinet meeting at the Yongsan office on Tuesday where issues on national health insurance were raised. [YONHAP]

President Yoon Suk-yeol took aim at healthcare "freeloaders," saying that the overly generous benefits offered first under the previous administration have to be scaled back to prevent fraud and waste.

“The reckless health insurance coverage expansion based on populist policies is bankrupting the national health insurance program,” Yoon said during the cabinet meeting on Tuesday.

“The normalization of health insurance, which is the last safeguard in protecting the people’s health, is urgent,” Yoon said. “In the last five years, some 20 trillion won was spent to strengthen coverage.

“Yet as the government has ignored medical service abuse and freeloaders, that cost has been paid by the majority of the people.”

Reforming health care is not a choice, he argued, but a necessity.

“We need to strengthen the requirements for health insurance recipients and prevent waste and leakage in health insurance,” Yoon said. “The resources saved will then be used to support people caught in medical blind spots.”

Health care benefits can be reduced by the executive by adjusting policy, though any increase in benefits might require legislation.

The president stressed that the central purpose of national health insurance is to provide medical bill coverage for people in need, such as patients with serious illnesses whose medical bills are high.

“We will improve sustainability while strengthening the necessary medical services and the treatment of patients with serious illnesses,” Yoon said.

The government also plans to change rules for foreigners in Korea, as some recent arrivals have sought expensive care.

Abuse of national health insurance has become a major key concern.

According to a study by the Finance Ministry and the Health Ministry, in one case, a person in his or her 60s last year received 1,425 outpatient treatments, including physical therapy, at 19 different medical centers.

On one day, the person visited eight medical centers.

The government noted that some patients treated physical therapy as massages while billing national health insurance.

In another case, a 40-year-old patient with a simple headache last year was given several tests, including an MRI. The national health insurance paid 720,000 won for the MRI, which turned out to be unnecessary.

A 52-year-old with indigestion was given six different medical tests including an ultrasound test, and 1.15 million won was covered by national health insurance.

The cost for national health insurance-covered MRIs, which was one of key symbols of expanded medical service under the previous administration, surged from 189.1 billion won in 2018 to 1.8 trillion won last year.

This year, the national health insurance is expected to record a 1 trillion won surplus, which is a drop from 2.8 trillion won last year. Next year it is expected to record a 1.4 trillion won deficit.

Policyholder reserves, currently 21 trillion won, will be exhausted by 2028.

A rapidly aging population is heavily taxing health insurance finances, and the expanded coverage under the previous administration made the situation worse.

Measures being considered by the Health Ministry include a limit to testing covered by national health insurance and capping the number of medical centers a person can visit in a single day.

BY LEE HO-JEONG [lee.hojeong@joongang.co.kr]