As hospitals over-medicate using loss insurance and patients continue to shop for medical care, the government pulled out a knife.
In the case of non-diagnostic treatment such as manual treatment or extracorporeal shock wave treatment, the direction is to increase the out-of-pocket cost of real loss insurance.
I'm reporter Baek Jong-gyu.
[Reporter]
This is the detailed settlement of medical expenses for patients who received hospital treatment for cervical pain.
More than 160,000 won was charged, of which 150,000 won were manual therapy, extracorporeal shock wave therapy, and non-payment items.
However, if you have real loss insurance, you can get a significant portion of the non-benefit items of 150,000 won back.
From the patient's point of view, you can receive expensive treatment for a small amount of money.
As a result, there is a vicious cycle in which the interests of patients and medical staff are intertwined to receive non-payment treatment without hesitation and hospitals continue over-treatment.
The total amount of real loss insurance from 2021 to August this year has exceeded 7 trillion won, and this year is expected to exceed 2 trillion won, which is the amount of insurance paid last year.
As the side effects of non-benefit and loss insurance grew, the government decided to pull out the knife.
[President Yoon Suk Yeol (Last month, 29th, Cabinet meeting)] If non-benefit and non-life insurance are not in harmony with public insurance, it is like pouring water into the bottomless jar. Please come up with an improvement plan for real loss insurance within this year.]
First of all, a plan to pay and manage non-severe over-treatment, manual treatment, and extracorporeal shock wave treatment will be promoted.
This will equalize all different treatment costs for each hospital and increase the patient's burden.
It is also reported that they are considering ways to limit the number of treatments by limiting the coverage of real loss insurance.
Earlier, the government said it would also limit pay for so-called "mixed care" that receives physical therapy, which is a non-payment, at the same time.
However, there are also concerns that good loss insurance subscribers who need real treatment could suffer damage.
In addition, from the perspective of consumers, there are voices that there should be support measures such as a reduction in insurance premiums as real loss insurance coverage decreases.
The Presidential Special Committee on Medical Reform plans to gather public opinion and announce measures to improve the real loss insurance system, including restrictions on mixed medical treatment, within the next month.
I'm BAEK JONG KYU of YTN.
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