J Korean Med Assoc.  2015 Apr;58(4):264-270. 10.5124/jkma.2015.58.4.264.

Review on the current reformation of the physician surcharge in Korea

Affiliations
  • 1Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea. docmohw@snu.ac.kr

Abstract

The reform of the physician surcharge system in Korea, which was applied beginning August 1, 2014, reduced the financial burden from three major non-covered services. However, hospital financial balances, already negatively affected by the longstanding impact of lower reimbursement from the social insurance system, are likely to decline further. Now is the time for the Korean government to introduce policies that can solve the fundamental problems, caused by low contributions and a limited benefit design, that have distorted health care system. Tertiary care hospitals cannot expect significant revenue from increasing the numbers of beds and expensive equipment, as in the past. Tertiary care hospitals are members of the public health system and are social enterprises intended to contribute to the development of society. Policies should reinforce the traditional hospital model, with a focus on high quality of care, educational training, research, and public health leadership, but also on development of new business models, such as official development assistance and medical tourism. Above all, the government should accept that, in contrast to economy market rules in many other contexts, medical services are not determined according to supply and demand. The government must seek amendment of the relevant laws and regulations, including sustainable benefit plans, in order to provide high quality of care. For the successful implementation of government reform, the government should not ignore procedural justice in the allocation of resources.

Keyword

Universal health coverage; Reformation of physician surcharge; Tertiary hospital; Procedural justice; Korea

MeSH Terms

Commerce
Delivery of Health Care
Jurisprudence
Korea
Leadership
Medical Tourism
Public Health
Resource Allocation
Social Control, Formal
Social Justice
Social Security
Tertiary Care Centers
Tertiary Healthcare

Reference

1. Korea Ministry of Health & Welfare. Enhance the benefit coverage for four major disease and reducing financial burden from 3 major non-covered services including physician surcharge, private room charge and private charge for custodial care [Internet]. Sejong: Korea Ministry of Health & Welfare;2014. cited 2014 Mar 16. Available from: http://www.mw.go.kr/sotong/cy/scy0105ls.jsp?PAR_MENU_ID=12&MENU_ID=12040506.
2. Kim Y. Towards universal coverage: an evaluation of the benefit enhancement plan for four major conditions in Korean National Health Insurance. J Korean Med Assoc. 2014; 57:198–203.
Article
3. Dailymedi. Adverse balance of medical yields in Samsung Medical Center and Seoul University Hospital [Internet]. Seoul: Dailymedi;2015. cited 2015 Mar 13. Available from: http://www.dailymedi.com/news/view.html?smode=&skey=%BB%EF%BC%BA+805&x=19&y=9&section=1&category=4&no=788354.
4. Korea Health Industry Development Institute. 2013 Pharmaceuticals, medical device, cosmetics, food, bio, health care service. Cheongwon: Korea Health Industry Development Institute;2014.
5. Korea Ministry of Health & Welfare. Designation of 43 tertiary care hospital: 2015-2017 [Internet]. Sejong: Korea Ministry of Health & Welfare;2014. cited 2014 Dec 23. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=315659&page=7.
6. Korea Ministry of Government Legislation. Act on the establishment of national university hospital [Internet]. Sejong: Korea Ministry of Government Legislation;2014. cited 2014 Jan 7. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=149543&ancYd=20140107&efYd=20140107&ancNo=12177#0000.
7. Korea Ministry of Government Legislation. Act on the establishment of Seoul National University Hospital [Internet]. Sejong: Korea Ministry of Government Legislation;2014. cited 2014 Jan 7. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=149534&ancYd=20140107&efYd=20140107&ancNo=12179#0000.
8. Ferrinho P, Van Lerberghe W, Fronteira I, Hipolito F, Biscaia A. Dual practice in the health sector: review of the evidence. Hum Resour Health. 2004; 2:14.
Article
9. Korea Ministry of Health & Welfare. Reformation of physician surcharge [Internet]. Sejong: Korea Ministry of Health & Welfare;2014. cited 2015 Mar 16. Available from: http://www.mw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=302113&SEARCHKEY=TITLE&SEARCHVALUE=%BC%B1%C5%C3%C1%F8%B7%E1%BA%F1.
10. Lee JK. Current issues on reformation of physician surcharge, SNUH e-health policy [Internet]. Seoul: Seoul National University Hospital;2014. cited 2014 Mar 16. Available from: http://www.snuhfund.com/webmail/20140318/37-hotissue.html.
11. McKee M, Healy J. The role of the hospital in a changing environment. Bull World Health Organ. 2000; 78:803–810.
12. World Health Organization. Role of hospitals in programmes of community health protection; first report of the Expert Committee on Organization of Medical Care. Geneva: World Health Organization;1957.
13. Shin YS, Kim YI. Health policy and management. Seoul: Seoul National University;2013. .
14. National Health Insurance Service. Survey on private room charge and physician surcharge 2013 [Internet]. Seoul: National Health Insurance Service;2014. cited 2013 Oct 10. Available from: http://blog.daum.net/nhic-hongbo/3355.
15. Park JS. Current issues on reformation of resident training programme. Joint Symposium of SNUH and SNUMC on Spring 2014 [Internet]. Seoul: Seoul National University Hospital;2014. cited 2014 April 23. Available from: http://www.snuh.org/pub/snuh/sub02/sub05/1183349_3955.jsp.
16. Hartstein M. Medicare payment: graduate medical education disproportionate share [Internet]. Washington, DC: Institute of Medicine;2013. cited 2013 Mar 16. Available from: http://www.iom.edu/~/media/Files/Activity%20Files/Workforce/GMEGovFinance/HartsteinPresentation.pdf.
17. Henderson T. Medicaid graduate medical education payments: a 50-state survey [Internet]. Washington, DC: Association of American Medical Colleges;2013. cited 2013 Mar 16. Available from: http://dhhs.nv.gov/uploadedFiles/dhhs.nv.gov/content/About/GMETF/2014/2014-05-14_Item12a_Medicaid_GME_2013_Report_AAMC.pdf.
18. Korea Ministry of Health & Welfare. Report on planning for research driven hospital. Seoul: Korea Ministry of Health & Welfare;2011.
19. Wang SJ. Principles and system of disaster medicine. J Korean Med Assoc. 2014; 57:985–992.
Article
20. Legislative Analyst's Office. California children's hospital bond act of 2008 [Internet]. Sacramento: Legislative Analyst's Office;2007. cited 2014 Mar 16. Available from: http://www.lao.ca.gov/ballot/2007/070659.aspx.
21. Japan National Center for Child Health and Development. 2012 Annual report [Internet]. Tokyo: National Center for Child Health and Development;2014. cited 2014 Mar 16. Available from: http://www.ncchd.go.jp/center/information/report/24/3-5-3.pdf.
22. Japan Ministry of Health, Labor and Welfare. Act for independent administrative agency to perform the research concerning the highly specialized medical care. Article 26 [Internet]. Tokyo: Japan Ministry of Health, Labor and Welfare;2008. cited 2014 Mar 16. Available from: http://law.e-gov.go.jp/htmldata/H20/H20HO093.html.
23. Daniels N. Setting limits fairly on the way to more comprehensive universal coverage: 14th Global Health Academia [Internet]. Seoul: JW LEE Center for Global Medicine;2014. cited 2014 Dec 29. Available from: http://www.jwleecenter.org/globalm/projects/education_view.php?key=&keyword=&bd_id=867.
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