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| Health minister Cho Kyu-hong delivers an opening speech at a public hearing held on measures to enhance health insurance sustainability and support essential medical care at a hotel in Seoul, Thursday. Yonhap |
By Lee Hyo-jin
The Ministry of Health and Welfare will apply stricter standards on insurance coverage in Magnetic Resonance Imaging (MRI) checkups and ultrasound scans, undoing the healthcare insurance expansion policies adopted by the previous Moon Jae-in administration.
The government will also adopt tougher measures to screen health insurance coverage of foreign residents' dependents by obligating them to reside continuously in Korea for at least six months in order to become eligible for the state healthcare program.
The health authorities will also come up with ways to limit coverage for those who are suspected of reaping healthcare benefits by conducting unnecessary examinations or consultations.
These measures intending to overhaul much of the health insurance policies introduced by the previous Moon administration ― dubbed "Mooncare," which aimed to strengthen Korea's national healthcare coverage similar to Obamacare in the U.S. ― were unveiled during a public hearing, Thursday, to gather opinions on how to "enhance health insurance sustainability and support essential medical care."
The event, held at a hotel in Seoul, was attended by Health Minister Cho Kyu-hong, medical experts, and members of groups representing doctors, patients and consumers.
"In the past five years, health insurance coverage has expanded substantially, bringing with it positive effects of widened public access to healthcare services," said Cho. "However, it has led to side effects such as the unnecessary exploitation of medical services, which have caused a heavy burden on national health insurance expenditures."
He added, "Reimbursements of MRIs and ultrasound scan fees were expanded to fields that were irrelevant to a patient's disease and condition. As a result, medical expenses (for MRIs and ultrasound scans) increased by tenfold between 2018 and 2021."
The ministry will soon establish a committee with medical groups to come up with detailed measures on how to optimize the reimbursement system for MRI and ultrasound scans.
The ministry also seeks to apply stringent standards to the dependents of foreign nationals in the National Health Insurance Service (NHIS). Health authorities say they have been grappling with a rise in "free riders" among foreign national dependents who have exploited the system.
Between 2017 and 2022, while the total number of dependents registered with the NHIS has decreased steadily from 20 million to 17.9 million, the number of dependents of foreign nationality has risen from 182,000 to 195,000.
Unlike Korean nationals, whose income and assets can be more easily calculated, it is harder for the government to calculate the income and assets of foreign nationals, thus making it difficult to sort out those who are not eligible to become a dependent.
The overhaul in health insurance expenditures comes as "Mooncare," has come under growing scrutiny for deteriorating the NHIS' financial sustainability. With the ambitious goal of raising the state health insurance coverage rate up to 70 percent by 2022, the Moon administration sought to expand public health coverage for a wider range of medical treatments, including costly ultrasounds and MRIs as well as the use of emergency rooms.
In the first half of this year, health insurance medical expenses exceeded 50 trillion won for the first time since the state insurance scheme was introduced. The monthly premium rate on salaried workers has reached 7.09 percent, close to the legal limit of eight percent.
Meanwhile, the ministry added that the saved expenditures will be spent on improving essential medical care directly related to people's lives as well as medical costs needed in the case of national disasters. It will also improve compensation and payment conditions for medical professionals working in emergency rooms or those who perform complicated surgeries.
The authorities also vowed to address the widening gap in medical services between big cities and rural areas, but did not come up with detailed measures other than deploying more resident doctors to rural hospitals.
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