President Lee Jae-myung, at a Ministry of Health and Welfare briefing on the 16th, said, "The current medical system remains a patchwork fix that leaves the causes of the problems unaddressed," calling for a structural overhaul of health insurance and essential care overall. The point is to sharply strengthen compensation for severe and essential care while cutting funding that is excessively poured into minor cases like colds.
At the briefing held that afternoon at the Government Sejong Convention Center, Lee cited the aversion to essential specialties such as thoracic surgery, neurosurgery, obstetrics and gynecology, and pediatrics, noting, "The reasons doctors are disappearing are already well known: low fees, excessive liability for medical accidents, and the burden of being on standby 24 hours." He added, "Even if we increase regional doctor programs or public medical schools without removing the causes, the same problems will recur over time."
In particular, he strongly criticized the fact that the current National Health Insurance fee schedule is designed to be overly favorable to minor care. Lee said, "For minor illnesses that often don't require a visit, out-of-pocket costs are excessively low, while compensation for life-and-death major surgeries and childbirth care is woefully inadequate," stressing, "If we don't normalize the compensation system, the collapse of essential care is unavoidable."
Lee said, "Medical reform can be an unpopular policy," but added, "We need to have an honest debate with the public that a society where some share a bit more of the burden for cold treatment is better than a society where people lose their lives because they can't receive severe care." He then asked the ministry to "actively explain to the public the rationale for securing resources by cutting unnecessary expenditure."
On this, Health and Welfare Minister Jung Eun-kyeong said, "We plan to push early next year for an overall fee adjustment that will recalibrate some overcompensated test and imaging fees while raising fees for essential and severe care."
Lee also took issue with the civil and criminal liability framework for medical accidents. Lee said, "In a system where one surgical error can leave an individual saddled with tens of billions of won for life, who will take on high-risk surgeries?" adding, "We need a system that combines insurance and state responsibility, like traffic accidents."
Accordingly, the ministry is moving to expand support for liability insurance for physicians in essential specialties and to ease the burden of criminal punishment by revising the Medical Dispute Mediation Act. However, Lee said, "We need to review whether current insurance limits sufficiently reflect reality," calling for bolder institutional improvements.
To close regional gaps in care, a plan was presented to foster national university hospitals as hub responsibility hospitals and to reorganize tertiary general hospitals to focus on severe care. Regarding severe trauma centers and doctor helicopter operations, Lee noted, "They are overly dispersed, reducing efficiency relative to expense," and said, "We can adequately respond by concentrating at the metropolitan level."
Starting next year, the ministry plans to gradually foster metropolitan hub trauma centers and to reorganize the helicopter transport system accordingly.
Meanwhile, Lee also addressed issues of high interest to younger generations, such as hair-loss and obesity treatments, saying, "While maintaining the principles of insurance and fiscal sustainability, we need to ensure intergenerational deprivation does not grow." He added, "If unlimited coverage is difficult, we could also discuss practical alternatives, such as limits on the number of times or aggregates."