The government has forecasted that if the emergency medical care system, which has been operational for two years to reduce damage from conflicts between the government and the medical community, continues this year, the cumulative deficit of health insurance will increase significantly.
According to the 'Health Insurance Financial Outlook' submitted by the National Assembly Budget Office to Rep. Jin Seon-mi of the Democratic Party of Korea on the 16th, if the government maintains the emergency medical care system, which has been in operation since February last year, until the end of this year, the cumulative health insurance deficit is expected to increase by 1.7 trillion won. This figure is compared to an estimate assuming that the emergency medical care system was terminated at the end of last year.
Earlier, the government raised the health crisis alert to 'serious' starting in February last year and has been operating the emergency medical care system to minimize disruption in the treatment of severe and emergency patients. The government has been supporting medical institutions to maintain this treatment system using health insurance finances. Until the 'serious' phase of emergency medical care is lifted, 208.5 billion won will be supported monthly through health insurance, and advanced payments have been made to training hospitals.
In addition, the health insurance fees for some treatments have been temporarily increased. The health insurance finances injected by the government from February last year to January this year amount to 1.4157 trillion won. These funds were utilized to maintain the emergency medical care system, transport mild patients, and provide inpatient treatment for severe and emergency cases, as well as general inpatient care. However, the amount not paid due to medical institutions not claiming fees is not included, so the total amount of aggregates in future support is expected to increase.
Additionally, the amount of health insurance payment prepayment paid to training hospitals facing management difficulties due to a collective resignation of residents from July to September last year is 1.4844 trillion won in total. Each training hospital must repay the prepayment starting in April this year.
If the government had operated the emergency medical care system until December of last year and then ended it, the transition to a deficit in health insurance finances was expected in 2026. However, as the financial resources deplete rapidly in response to the conflict between the government and the medical community, the health insurance finances are anticipated to return to a deficit this year. The Ministry of Health and Welfare noted that it would invest over 20 trillion won in health insurance finances over the next five years for 'fair compensation systems (normalization of fees)' and follow-up measures starting this year.
Rep. Jin Seon-mi pointed out, 'The government's irresponsible policy implementation ultimately leads to enormous financial input and severely damages the financial soundness of health insurance.'