Healthcare revision to benefit low-income earners
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By Lee Kyung-min
A revised healthcare plan announced by President Moon Jae-in is expected to help low-income earners, the elderly and children. The President said the revision will prevent household bankruptcy caused by heavy medical costs.
Under the plan, the government will spend 30.6 trillion won ($27.2 billion) by 2022 to reduce out-of-pocket household medical spending to less than 30 percent, down 6.8 percentage points from the current 36.8 percent.
According to 2014 data from The Organization for Economic Co-operation and Development (OECD), out-of-pocket household medical spending in Korea was the second largest after Mexico where households have to pay more than 40 percent of the cost. Koreans pay more than twice the OECD average (19.6 percent).
Other than cosmetic surgery procedures, the government will have about 3,800 treatments insured under the National Health Insurance Service (NHIS) including magnetic resonance imaging (MRI) and ultrasound.
This is to stop hospitals from profiting by recommending such expensive treatments, something a sick person cannot afford to refuse.
According to data from the Ministry of Health and Welfare, as of 2015, out of 69.4 trillion won in medical spending, 57.9 trillion won was insured treatment, 44 trillion won paid by the NHIS and 13.9 trillion won paid by patients. The remaining 11.5 trillion won was uninsured, which patients had to shoulder without state support.
The measure will remove “selective treatment,” an option for which a patient has to pay an additional 50 percent of medical fees to get a professional opinion from doctors with over 10 years of experience.
So far, cancer patients have been paying the full cost of their anti-cancer drugs which cost up to 100 million won a year. The government will shoulder between 30 and 90 percent of the cost of expensive drugs.
Starting in the latter half of next year, the ministry will pay between 20 and 50 percent of the cost needed to stay in premium hospital wards.
Most patients stay in a ward with over four beds as they pay only 20 percent of the cost. But if all wards are full, patients have no other choice than to stay in wards with three beds or fewer, for which they have to pay the full cost.
Low-income households that earn less than the median income will pay only up to 1.5 million won down 550,000 won from the current 2.05 million won.
Parents with children aged 15 and younger will bear only up to 5 percent of the total cost. Currently, those with children aged below six bear up to 10 percent of the total.
Starting October, patients with severe dementia will pay only up to 10 percent of the total cost, significantly down from the current 69.8 percent. About 240,000 such patients will benefit.
The government will pay between 50 percent and 70 percent of the cost spent on the elderly in need of dentures and dental implants.
Women undergoing infertility treatment will be given more state support with the specified benefit standardization to be completed in October. Currently, the government pays up to 3 million won to women up to age 44.
However, should patients choose to undergo expensive uninsured treatment that has yet to be verified for its safety, validity or cost-effectiveness, the government will cover only up to 50 percent of the total cost.
Concerns remain
The government said it would use about 10 trillion won, almost half of the 21 billion won profit made from running the NHIS thus far.
It said it would continue the policy of raising the national health insurance rate by up to 3.2 percent every year.
But opposition parties and the medical community _ mostly doctors _ raise concerns that the government has no concrete plan to secure financial resources.
While many of them agree the new welfare plan is a step in the right direction, they say it will definitely cause a huge financial burden on taxpayers in the long term.
The country, they add, will be unable to generate enough tax revenue due to the aging population and low birthrate.
Doctors say they are forced to sacrifice, adding the measure fails to give due consideration to the inevitable decrease in hospital revenue.