The Presidential Medical Reform Special Committee has resumed discussions on "real insurance reform." The insurance industry is hoping for the swift introduction of a long-awaited non-covered service management plan. However, due to remaining procedures such as public hearings, the final proposal is expected to be unveiled early next year.
On the 27th, according to the insurance industry and others, the Essential Medical and Fair Compensation Subcommittee under the Special Committee held a meeting the previous day to discuss real insurance and non-covered service management plans. It has been about three weeks since related discussions were suspended after the declaration of a state of emergency on Dec. 3.
The financial authorities disclosed the prepared real insurance reform plan at this meeting and listened to the opinions of the experts. The key point of the proposal presented by the financial authorities is reportedly to reduce compensation for mild illnesses compared to the current levels. This is interpreted as an effort to prevent excessive treatments where unnecessary procedures are performed to obtain insurance payouts. They also reaffirmed their position that non-severe excess non-covered services, such as manual therapy, need to be managed. The Korean Hospital Association also attended this meeting.
However, the proposal to be presented at the public hearings has not yet been decided. The reform plan will be finalized after the subcommittee selects one of several proposals and goes through public hearings to gather opinions from various sectors. One Commissioner who attended the meeting noted, "There are differing opinions, so it has not been decided which proposal to suggest at the public hearing."
Accordingly, the real insurance reform plan is expected to be disclosed early next year. Since a public hearing was previously scheduled, the view is prevailing that practical preparations are complete. As various discussions have taken place in subcommittees, claims have emerged that the participation of the medical community will not be a significant obstacle.
The insurance industry is showing optimism at the news that the Special Committee is resuming discussions. An insurance industry official stated, "The financial authorities have done everything they could thus far, and there have been results; however, in a medical environment without a non-covered service management mechanism, there are bound to be limitations." They added, "It has been said that medical reform must progress regardless of the state of emergency or impeachment, and now we must wait for the results."
Reform of real insurance is being advanced by the Insurance Reform Council led by the financial authorities and insurance industry, as well as by the Special Committee which includes the health authorities and medical community. The financial authorities are focusing on changing the structure of real insurance products to prevent moral hazards such as excessive treatments, while the health authorities are pursuing plans for managing non-covered services.
The insurance industry has shown more interest in the non-covered service management plans. This is because the structural changes to products promoted by the financial authorities have already been carried out several times but have not yielded significant effects. In reality, while non-covered service clauses have been introduced, alongside premium discount and surcharge systems, the soaring loss ratios could not be contained. The insurance industry believes that changing the product structure again will not prevent excessive treatments. The key is the non-covered service management mechanism.
Earlier, the Special Committee planned to hold a public hearing on the 19th, but the schedule was indefinitely postponed due to the declaration of a state of emergency. The financial authorities stated they would unveil the real insurance reform plan within this month despite the state of emergency, but no results were disclosed at the Insurance Reform Council meeting held on the 16th. It seems that the schedule was delayed as the key non-covered service management plan has become unclear. A financial authorities official remarked, "We are coordinating the schedule with the Ministry of Health and Welfare."
With the Special Committee restarting discussions, it is expected that the financial authorities will also resume discussions on the reform plans. A financial authorities official stated regarding the announcement of the real insurance reform plan, "We are coordinating the schedule with the Ministry of Health and Welfare."