Measures against exhaustion of medical insurance fund

An executive of the National Health Insurance Corporation (NHIC) in charge of medical insurance fund often asks, ``What shall we do next year and in the future?’’

The corporation had planned to secure 1 trillion won by raising the premium and additional subsidy of 1 trillion won from the stage coffer and save about 1-1.5 trillion won in order to prevent its bankruptcy. But the ruling party foiled its plan, raising a doubt of efficiency of plans under scrutiny.

▽ Concerns about rough-and-ready measures

The plan that the Ministry of Health and Welfare and the NHIC were originally about to announce had been prepared after two months of examination by working officials after the exhaustion of the medical insurance fund was expected.

However, the ruling party demanded that the government lower the increase rate of the premiums and instead secure 2-2.5 trillion won through the curtailment of expenditure apparently in mind the expected anger of the people last weekend. So, the ministry and the corporation are working out other plans in such a way as to ``squeeze a dry towel.’’

The government plans to announce a comprehensive plan which it prepared just in a week hastily early next week. Critics say that the government and the ruling Millennium Democratic Party are going to ``unprepared measures’’ in order to avoid the ``rod.’’

Such expected measures include, among others, a scheme to reduce the expenditure of insurance money by strengthening the screening of illegal or false requests for the payment of medical fees. However, the ministry and the corporation have not yet set the target amount to be curtailed without proving if hospitals or drugstores are swelling up their charges and how many such hospitals or drugstores are.

The reduction rate of the medical charges by the Health Insurance Review and Evaluation Board is 0.7 percent on average. This means that the corporation pays 99.3 won for the request of 100 won by hospitals or drugstores. It is doubted that the board can detect improper request without the increase in manpower and any drastic change in the method of screening

▽ Another conflict expected

The medical circle is protesting the plan to slash the medical charges, if it does not follow the ``rate of prescribing medicines of high price and injections’’ set by the government, condemning it as ``infringing upon the medical right.’’

One of the expected effects from the medical reform to separate the roles of doctors and pharmacists was that ``medicines of low quality’’ would be expelled, if the contents of the prescriptions were made public. But the government plan is designed to institutionally prevent doctors from prescribing expensive but good medicines for their patients according to their belief.

The corporation has decided to lay off 1,000 employees in order to curtail 44 billion won in management expenses. It will receive applications for retirement from volunteers. If the number is short of the earlier set number, the corporation will seek to lay off the workers forcibly, heralding a friction with the labor union.

It is difficult for the corporation to raise the collecting rate of the premiums of the regional insurance for non-wage earners to 97 percent from the present 92 percent within this year. If the premiums go up despite the economic stagnation, the subscribers may feel heavier economic burdens, causing a possible increase in default of payment. A similar phenomenon occurred when the nation was hit by a currency crisis in late 1997.

Song Sang-Keun songmoon@donga.com