Proposal for medical insurance deductible

Many people no doubt consider that insurance fees have increased too much in the wake of the recent adjustment of the doctors` fees. The adjustment came with the implementation a policy to separate the professional roles of doctors and pharmacists. Nonetheless, the medical insurance system is on the brink of collapse.

The main reason is that, under the present medical insurance financing system, income has never exceeded expenditures. Despite the resistance of ordinary citizens to the sharp hikes in medical insurance fees, the disbursement of insurance money has been steadily increased to meet the demand for better medical services and cater to the needs of the rising number of elderly people. During the past five years, the increase rate of medical insurance revenue stood at 14.4 percent, whereas that of its expenditures reached 18.5 percent. Last year saw a deficit of one trillion won.

However, related government authorities cannot avoid taking some responsibility for the insolvent state of the medical insurance industry. Due to the negative effects of the integration of the divergent insurance systems governing the regional, professional, public officials and teachers` sectors, medical insurance authorities failed to formulate proper medical fees and make up for deficits in the 19 months since May 1999. This is to say that the authorities should have foreseen the deteriorating state of medical insurance sector`s finances and raised the insurance fees in a timely manner. In fact, the level of our insurance fees is considerably lower than that of the advanced nations, where it typically stands at 8-11 percent.

And there has been a significant amount of money wasted due in the course of paving the way for the integration, management and operation of the medicare system.

Most important now is to stabilize the medical insurance system`s finances. It seems that is why the Health-Welfare Ministry underlined the financial stabilization program for the medical insurance system in its administrative briefing at Cheong Wa Dae on Tuesday. The gist of the briefing was that the ministry plans to curb factors leading to increased insurance fees by carrying out self-rescue efforts by lowering the prices of insured medicines, laying off employees at the medical insurance corporation, expanding the state subsidy, more effectively collecting insurance fees and tightening insurance fund outlays.

At the same time, envisioned is a gradual increase in insurance fees and the introduction of a medical insurance savings system and a deductible on low-cost medical treatments.

Under the proposed medical insurance savings system, some of the existing insurance funds would be drawn out of and deposited in individual accounts. If their insurance fees need to be defrayed, the money will be paid through their account. This method is hoped to be conducive to curbing insurance fund disbursements. Yet problems remain as the kinds of illness to which the deposited money applies and ceilings on the deposited money. The deductible system would contribute to insurance financing stabilization.

The new medical insurance system also calls for a reduction of the financial burden on patients with incurable diseases and those requiring expensive treatments. The compelling question is how effective the new system will be. Prior to the actual implementation of the proposed medical insurance system, authorities will have to work out detailed action plans and win the endorsement of the insured.