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Korean Medical Association Criticizes Insurance Control Plan

by Dr. Michael Lee – Health Editor

Medical Association Criticizes national Assembly Report on Healthcare Costs

Seoul, south Korea – The Korean Medical Association (KMA) ‍has issued ⁣a strong critique of a recent report from the National Assembly Future Institute concerning the control of non-benefit healthcare services and actual loss insurance.the KMA argues the report unfairly places blame‌ on ​the medical community while overlooking systemic issues driving rising healthcare costs.

The report identifies ⁣the expansion of non-covered medical services, concurrent treatment practices (parallel treatment), and generous actual⁣ loss insurance structures as key threats to the financial stability of the national health insurance system. While acknowledging these concerns, the KMA contends⁢ the​ report’s analysis is ‍biased,‌ attributing the problems solely to medical institutions seeking profit maximization and⁤ conflicts with professional autonomy.

According to the KMA, the root ⁣cause of the growth in non-covered services lies in the government’s long-standing policy of low⁤ reimbursement rates for covered procedures. Medical institutions, operating ⁤at a loss under current fee structures, are compelled to offer non-covered treatments to maintain financial‌ viability. The KMA insists that realistic fee schedules are a prerequisite to any effective control of non-covered services.

The KMA ‍also expressed concern ‍over proposed ⁣restrictions on concurrent treatment. They ​argue that prohibiting patients from receiving both covered and ⁤non-covered services within the same facility could limit patient choice and hinder access ⁣to care, particularly for ⁣the elderly and those with chronic conditions who​ benefit from continuity of treatment.They highlight ⁤that the current system of allowing parallel treatment has contributed to high accessibility ⁢and efficiency within the Korean healthcare system.

The association supports a gradual ​expansion of coverage for non-covered services with demonstrated medical necessity, but stresses this must be approached cautiously. ⁣ Any such expansion requires thorough public‌ debate, scientific‍ verification, and ⁣a ‌comprehensive plan to ensure financial sustainability. ⁢ furthermore, the KMA warns that simply restricting ⁤non-covered services without addressing underlying issues​ could lead to a “balloon effect,” resulting in the emergence of new, unregulated⁣ non-covered treatments.

the KMA emphasizes the need to address fundamental structural problems within the⁤ insurance system,including flaws in insurance product design and the inadequate compensation for actual costs,before focusing on⁤ controlling non-covered services.

Source: MediGate News report dated November 6th.

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