Monday, December 8, 2025

Special Envoys Needed to Combat Illegal Health Insurance Practices

by Dr. Michael Lee – Health Editor

Summary of the Article: “Another power to introduce an envoy, protect national health insurance

This article argues for the introduction of a special judicial police system (envoy) to combat illegal medical institutions (like “secretariat hospitals” and pharmacies renting licenses) in South Korea and protect the national health insurance system.

Here’s a breakdown of the key points:

The Problem: Illegal medical institutions are draining the national health insurance fund through ⁤over-care and false claims. ​ While the National Health Insurance Corporation is trying to address this, recovering funds is slow, difficult, and often incomplete. Operators often hide assets and‍ evade accountability.
The Solution: Special Envoys: Granting investigative authority to employees⁣ of the National Health Insurance Corporation (similar to⁤ how it’s done for food/drug safety, forestry, and environmental protection) would allow for quicker and more effective ‌crackdowns on illegal practices.
Why it’s Needed now: South Korea⁤ is an aging society with rapidly increasing healthcare costs.Allowing illegal ‍institutions to continue operating threatens⁤ the sustainability of the health insurance system.
Growing Support: The idea has gained traction with resolutions passed by the National Assembly and⁢ local ⁤councils, and is ⁤being discussed by the government.
Impact: The author, Bae-ja,‌ Chairman of Busan Dongnae-gu Women’s Organization Council, frames⁣ this as a matter of protecting the health and financial well-being of families and communities. She believes it’s a crucial step in safeguarding ‍the national health insurance system. Financial Impact: In 2023, unfair claims related to illegal medical institutions⁣ amounted to approximately 800 billion won, totaling⁤ over 4 trillion won in the last five years.

In essence, the article advocates for a more proactive and powerful ‌approach to tackling healthcare fraud to ensure the long-term viability⁢ of ⁣South Korea’s national health insurance.

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