From Emergency Treatment to Surgery at Local Medical Institutions... Discussion on 'Essential Medical Support Measures'

The 25th Health Insurance Policy Deliberation Committee Meeting

On the 22nd, Park Min-su, the 2nd Vice Minister of Health and Welfare, who attended the Health Insurance Policy Deliberation Committee, is speaking.
[Photo by Ministry of Health and Welfare]

[Asia Economy Reporter Lee Gwan-ju] Discussions were held regarding essential medical support measures, which recently became an issue due to the suspension of pediatric and adolescent care, and the Yoon Seok-yeol administration's health insurance reform plan targeting the 'Moon Jae-in Care.'

On the 22nd, the Ministry of Health and Welfare held the 25th Health Insurance Policy Deliberation Committee (Geonjeongsim) meeting and reported on support measures focused on severe emergency care, childbirth, and pediatric treatment to guarantee essential medical care that saves citizens' lives.

The measures include establishing a 'regionally comprehensive essential medical system' where severe and emergency patients are immediately transferred to local medical institutions, and emergency treatment, testing, and final surgery can be promptly performed at the respective medical institutions. To this end, the capabilities of major hospitals such as emergency medical centers and cardiovascular and cerebrovascular centers will be strengthened, and support will be provided to build cooperative systems such as specialist rotation shifts between hospitals. Additionally, support for childbirth-vulnerable areas will be enhanced, and pediatric cancer base hospitals will be expanded to reduce disparities in childbirth and pediatric care between regions.

Along with this, a practical system will be established by providing appropriate compensation through 'public policy fees.' Compensation will be expanded for areas with heavy workloads such as nighttime and holiday emergency surgeries, high-difficulty and high-risk surgeries, and cooperation between hospitals will also be compensated. To support the maintenance of the treatment base, childbirth fees and neonatal ward admission fees will be improved, and a pilot project will be promoted to compensate medical institutions for deficits incurred from severe pediatric care. Measures to secure sufficient essential medical personnel, such as prioritizing the placement of residents in local hospitals and essential departments to improve working intensity and reduce personnel gaps in the essential medical field, were also included.

A report was also made on the 'Health Insurance Sustainability Enhancement Plan (draft),' announced through a public hearing on the 8th. The Ministry of Health and Welfare stated that while extensive coverage enhancement policies have the positive effect of improving medical accessibility, they also induce excessive medical treatment, posing a threat to maintaining the financial soundness of health insurance, and thus proposed this plan. The Ministry plans to finalize it by synthesizing the discussions from Geonjeongsim and opinions raised at the public hearing.

Meanwhile, at this Geonjeongsim meeting, the performance evaluation results of nine health insurance pilot projects expiring this year and the future direction of the projects were also discussed. Through the discussion, eight projects, including the pilot project for home management of peritoneal dialysis patients, were decided to have their project periods extended, while the pilot project for home medical care for pregnant women in childbirth-vulnerable areas was terminated considering low participation rates and effectiveness. The Ministry of Health and Welfare stated, "We will continue to strive to establish more substantial medical service models during the operation of pilot projects to ensure that essential medical services are sufficiently provided to the public."