[Op-Ed] Fabricated Surgery

Nineteen people including gynecologists, nurses and staff at medical equipment firms have been arrested on the charge of conducting surgeries by fabricating test results and collecting fees for treatment from the National Health Insurance Corp. The suspects fabricated the test results to get surgery covered by national health insurance after a new regulation saying payment for treatment can be made only when urinal pressure in the belly stays below the level of 120cm H2O, and were paid 700 million won (600,000 U.S. dollars) from the national insurer. Doctors forced patients with urinary incontinence to undergo unnecessary surgery simply to get money from the government.

Middle-aged women who gave birth often suffer from leaking urine when walking or laughing due to loosened muscles that sustain the urinary bladder and urethra. Such patients feel shame and discomfort, but the disease is not life-threatening. Several years ago, private health care insurers started selling insurance policies covering urinary incontinence.

With an insurance product helping to improve their symptoms at low cost, women underwent urinary incontinence surgery en masse. As a result, the number of patients who got the procedure surged from 16,506 in 2001 to 73,870 in 2006. The health insurance budget faced a shortfall due to this trend, so a new standard was set in February 2007 on making women meet certain requirements to take insured surgery for urinal incontinence.

Urinal incontinence surgery might be easy to perform but hospitals and medical professionals who conduct unnecessary surgery on patients to make money face a huge responsibility. Even if experts debate whether urinal incontinence surgery is essential in the first place, forcing patients to undergo surgery by fabricating test results is unforgivable. Any surgery involves potential risk. However small a surgery is, it could entail lethal side effects if an infection is not managed properly. In this sense, no surgery is risk-free. When a doctor and a patient choose surgery, they should be 100 percent sure that the risk is lower than that of no surgery, and that the results of surgery are better than the alternative.

The latest incident brings to mind the words of Dr. John Lewis, a thoracic surgeon at Stanford University in the U.S. “Surgery is not something for patients but for surgeons,” he said. Just as investigative authorities such as prosecutors and police can conduct fabricated probes, doctors might also be performing unnecessary or fabricated surgery. Surgery risks the health and life of a patient. Doctors work to earn money like other people, but should never treat life and the human body lightly.

Editorial Writer Chung Sung-hee (shchung@donga.com)