The debacle in Korean medical insurance

SEOUL: The nation's medical insurance system is on the verge of bankruptcy. The National Health Insurance Corp. (NHIC) has estimated that its fiscal deficit would reach 3.97 trillion won at the end of this year. Without any drastic steps to meet the balance, including the government subsidy, the fund for insurance for company workers would be depleted in May, while the region- based insurance system for self-employed people would go into the red as from July, the corporation said.

This fiasco in the healthcare system had been widely anticipated. The current problem is mainly attributed to the government's miscalculation of the cost that the new medical system would incur. The government last year expected the medical reform, whose highlight was the separation of the roles of doctors and pharmacists in medical service, to incur an additional burden of about 1.5 trillion won on the NHIC this year. Government officials now say that the amount would reach 3.7 trillion won.

Various measures that have been taken so far were based on these erroneous estimates. The government has raised medical charges five times since last November. By approving these raises, the government succeeded in diverting the resistance from doctors who had taken to the street to protest the medical reform, which deprived them of the income from selling their own medicine. But the rapid increase in medical charges has placed an enormous financial burden on the medical insurance system.

Moreover, unlike the repeated claims of government officials, the new system has also failed to discourage the overuse or misuse of drugs, mainly antibiotics, in this country. Consumption of antibiotics hasn't dropped at all since the implementation of the new system. The new system has only enriched doctors and pharmacists without attaining its purported goal of serving the public.

President Kim Dae-jung and other government and ruling party officials have finally admitted their mistakes, saying that they hadn't been properly informed. Rumors are circulating about an imminent cabinet reshuffle, where Health and Welfare Minister Choi Sun-jung and other related officials are likely to be replaced.

The opposition Grand National Party is demanding the resignation en masse of all the cabinet members, including Prime Minister Lee Han-dong. The party also calls for a fundamental review of the nation's healthcare and medical insurance system.

The government is expected to announce soon a set of measures to relieve the financial strains in the medical insurance system, which will include plans to provide a government subsidy. The government will also reportedly announce measures to reduce expenditure by improving the insurance payment system. But these prescriptions are certainly short of bringing a fundamental solution to the troubled medical insurance system.

Moreover, they are highly likely to face resistance from doctors and pharmacists as well as the public. Civic organizations have already formed an alliance to fight against the government for its move to raise health insurance premiums.

In effect for only seven months, the new medical system has a long way to go before it brings to people the expected benefits. The separation of roles of doctors and pharmacists, in particular, has many long-term merits over the various problems that are occurring at the initial stage of implementation.

But before further pushing the new system, we need to review the whole system and seek ways on how to improve its finances.

It is disappointing to see the ruling party and government officials passing the bucks to each other for the responsibility of the failure. Many ruling party officials are pointing their fingers at officials of the Ministry of Health and Welfare, while the ministry officials are complaining that politicians should take responsibility for having pushed forward the medical reform despite anticipated problems.

It makes no sense to blame others at this critical time but those who are responsible for the current failure should take the responsibility. The public cannot be experimented on for the sake of some precarious policies.

-- The Korea Herald/Asia News Network