[메디게이트뉴스 하경대 기자] On the 6th, the Korean Medical Association criticized the ‘Non-benefit and actual loss insurance control plan’ report recently published by the National Assembly Future Institute, saying, “It overlooks the fundamental causes such as chronic low prices and structural problems and only blames the medical community.”
In particular, regarding the prohibition of concurrent treatment, the Korean Medical Association pointed out that “this may infringe on patients’ right to choose medical care and seriously impede access to medical care.”
In a statement on this day, the Korean Medical Association said, “We partially agree with the problem pointed out in the report that ‘the expansion of non-compensated medical services, parallel treatment practices, and generous actual loss insurance structures are key factors that threaten the financial sustainability of health insurance and deepen pathological phenomena in the medical system.’” “However, the report biasly attributes the causes of these problems only to ‘the profit maximization behavior of the medical community’ and ‘structural conflict with occupational freedom.’”
The Korean Medical Association criticized, “Although actual cost insurance should have been designed as a supplement to health insurance, we overlooked the fundamental causes of the structural problems resulting from errors in insurance company product design and the non-benefit compensation structure resulting from the low-cost policy,” and criticized, “The fundamental cause of the expansion of non-benefit is the government’s low-cost policy.”
In addition, he emphasized, “Medical institutions are unable to operate normally with benefits that are less than the cost, so they are inevitably forced to make up for the deficit through non-coverage treatment. Therefore, before controlling non-coverage, the government must first make efforts to make salary fees realistic, and create a foundation for medical institutions to continue providing sustainable treatment without relying on non-coverage.”
The Korean Medical Association then explained, “The ‘phased ban on parallel treatment’ and ‘non-coverage of insurance items’ proposed in the report may infringe on patients’ medical choices and seriously impede medical accessibility. In particular, parallel treatment is a system that allows patients to receive covered and non-covered treatment continuously within a single medical institution, and has contributed to maintaining high accessibility and efficiency in our country.”
At the same time, he said, “If parallel treatment is intentionally separated, the burden of travel for patients will increase, and there is a high risk that continuity of care for the elderly or chronically ill will be disrupted.”
In addition, the Korean Medical Association added, “To a certain extent, we agree with the efforts to gradually provide coverage for non-coverage items whose medical necessity has been proven. However, this must be promoted step by step on the premise of sufficient public debate, scientific verification, and a plan to secure stable finances. In addition, we must ensure that non-coverage control does not cause another balloon effect and result in the mass production of new non-coverage items.”
