NHIS and Medical Associations Begin Fee Negotiations... Korean Medical Association Absent

Jeong Gi-seok, Korea Workers' Compensation & Welfare Service Director: "Concerns Over Massive Financial Expenditure"
Medical Organizations: "Need for Fee Increase"

The National Health Insurance Service (NHIS) and medical organizations have entered into fee negotiations for 2025. The NHIS emphasized a reasonable balance due to concerns over 'financial expenditure' burdens, while the medical organizations called for breaking away from low fees and urged for fee increases.

On the 3rd, the NHIS held a joint meeting for the 2025 medical fee contract with medical organizations at the Seoul Garden Hotel in Mapo-gu, Seoul, attended by Lee Seong-gyu, President of the Korea Hospital Association; Choi Gwang-hoon, President of the Korea Pharmaceutical Association; Yoon Seong-chan, President of the Korea Oriental Medicine Association; Ma Kyung-hwa, Vice President of the Korea Dental Association; and Lee Soon-ok, President of the Korea Midwives Association. The Korea Medical Association (KMA) did not attend.

[Image source=Yonhap News]

Jung Ki-seok, Director of the NHIS, stated, "Although the financial balance has fortunately been in surplus for the past three years, the mid- to long-term financial outlook is not optimistic," adding, "Due to rapidly progressing low birth rates and aging, the working-age population is decreasing, and the insurance premium revenue base is weakening amid a low-growth trend."

He continued, "Expenditures such as hospital beds and equipment, which exceed the average of advanced countries, somewhat excessive testing, increased medical utilization, and financial input for essential medical policies are expected to explode in both scale and speed going forward."

He further said, "To ensure sustainable operation of health insurance, we will strive to find a reasonable balance by comprehensively considering the establishment of an essential medical system that provides treatment within the golden time to all citizens anytime and anywhere, maintaining medical infrastructure, and the impact on the national health insurance premium burden."

On the other hand, medical organizations expressed the need for a progressive fee increase.

Lee Seong-gyu, President of the Korea Hospital Association, said, "It is true that past negotiations focused on expenditure restraint and easing the burden on subscribers," adding, "From now on, we ask the NHIS to engage in more balanced negotiations to improve distortions in medical supply."

Choi Gwang-hoon, President of the Korea Pharmaceutical Association, stated, "The shrinking share of pharmacy service fees, drug price payments, increased credit card fees, increased workload due to longer prescriptions, frequent drug price reductions causing losses, increased workload from returns processing, disposal of unused drugs, drug losses, rising labor and management costs, and soaring prices have now reached the limit that pharmacies can bear," emphasizing, "Policy consideration for appropriate compensation is more urgently needed than ever."

Meanwhile, the KMA did not attend the joint meeting that day. Director Jung urged, "We hope that Chairman Lim Hyun-taek of the KMA and related parties will participate in the fee negotiations, which must be completed by the end of this month."

Starting with this meeting, the NHIS will enter into full-scale negotiations with medical organizations from the third week of May, and according to Article 45 of the National Health Insurance Act, the fee contract must be concluded by the 31st.