Doctors’ collective action
Laying down scalpels won’t win sympathy
Doctors Tuesday decided to refuse to perform operations for a week beginning July 1 in protest against the government’s plan to enforce the diagnosis-related group (DRG) payment system, sparking fears of turmoil in nationwide hospitals and clinics. The decision follows an agreement Sunday by eye doctors not to perform cataract operations.
We see the doctors’ refusal to operate as a dereliction of duty that can’t be justified and strongly urge the Korea Medical Association (KMA), which has led this latest collective action, to reverse the decision.
The DRG system will be applied to seven categories of medical services ― cataract, tonsils, appendix, hernia, hemorrhoids and uterine surgeries and cesarean sections ― at clinics and smaller hospitals from this July and at larger hospitals from July next year. Nearly 86 percent of clinics and 40 percent of small- and medium-sized hospitals have implemented the system since 1997.
The DRG system envisions applying fixed prices for the seven medical treatments to lower medical fees. The Ministry of Health and Welfare estimates treatment fees will be cut by an average 21 percent.
The DRG system is part of the government’s health insurance reforms aimed at putting the brakes on soaring health care spending. During the past 10 years, medical spending per capita increased by nearly 8 percent a year due partly to the current fee-for-service payment formula under which the National Health Insurance Corp. reimburses hospitals for each service they provide to patients.
The KMA has been demanding that the government scrap the new system, saying, ``It will only lower the quality of medical services.’’ Doctors say the fixed price of services will discourage them from providing proper and decent treatment. They also insist that the new system will put hospitals at a disadvantage because of its failure to reflect consumer price rises properly.
Doctors’ complaints are understandable and there should be more discussions before the DRG formula is introduced forcibly. Yet we have suspicions that their collective action may have something to do with the possibility of their income falling under the fixed-rate system, which has been denied by the government.
We accept the health ministry’s argument that the DRG system is an international trend and it will be instrumental in bringing down medical costs. Actually, a government study has shown that the fixed-price formula lowered medical costs by 14 percent by reducing unnecessary treatments and the use of antibiotics.
The DRG system was adopted by advanced countries such as the U.S. more than 10 years ago. In February, the Organization for Economic Cooperation and Development (OECD) advised Korea to expand the DRG system across the board.
Given people’s broad support for the new system, doctors’ refusal to perform operations won’t bring desirable effects. Rather, the public’s antipathy toward doctors will go from bad to worse. Doctors should know that their collective action that could put people’s right to receive treatment at risk won’t win any sympathy.