How to end the deep-rooted medical practice

The government has announced a plan to improve the current medical service delivery structure toward the direction of encouraging large hospitals to concentrate on patients with serious illnesses or emergency patients. It plans to cut the number of beds for general patients by up to 15 percent and divert them into intensive care units (ICUs), as well as increase the number of specialty doctors per bed. The government also wants to lower hospitals’ overreliance on trainee doctors for night shifts and replace them with specialty doctors and physician assistants.

So far, five major hospitals, including the Seoul National University Hospital and Samsung Medical Center, have been competing with neighborhood hospitals to draw patients with mild illnesses. As a result, a serious medical vacuum appeared in the medical service delivery system. The deep-rooted problems may finally be fixed in the wake of the massive resignations of trainee doctors protesting the medical school admissions quota increase. After large hospitals reduced the number of outpatients due to a lack of trainee doctors, the share of patients with grave illnesses rose to 45 percent from 39 percent in those hospitals. We welcome these new developments.

But if the reform is to succeed, the government must ensure that large hospitals remain financially stable even if they focus on treating critically-ill or emergency patients. University hospitals already suffer tens of millions of dollars in losses a month. A quick fix — such as temporary incentives or a minimal increase in the national insurance coverage rate for treatments at ICUs — cannot solve the problem. If hospitals face financial troubles, they have to turn to patients with lighter illnesses.

The government wants to change the insurance coverage system through a Health Insurance Policy Review Committee meeting later this year. But revamping the coverage rate was not easy due to fiscal limits.

The government would invest 10 trillion won ($7.2 billion) to revitalize vulnerable essential medicines by 2030. But given its past trajectory, the rescue package will not be enough to solve medical challenges. There will be a call for additional budgets, which should be covered by tax money. And yet, the government can’t do anything if it doesn’t ask for people’s cooperation.

The government must first fix problems with our current indemnity insurance system. Even when excessive medical treatments are in full swing thanks to the private insurance, the government still sits on its hands. The Health Ministry and the Financial Services Commission are shifting the responsibility for abusing medical services to one another. The government must first fix the insurance and ask people to share the burden.