"Increasing Compensation for Major Surgery and Anesthesia May Slightly Raise Patient Out-of-Pocket Costs" [Medical Reform Q&A]

Announcement of the First Implementation Plan for Medical Reform

The Presidential Commission on Medical Reform emphasized that now, facing the crisis of collapse in essential and regional medical care and the imminent transition to a super-aged society, is the "last opportunity to lead the normalization and qualitative maturation of healthcare in the Republic of Korea."

[Image source=Yonhap News]

No Yeonhong, Chair of the Medical Reform Special Committee, announced the 'First Medical Reform Implementation Plan' deliberated and resolved at the 6th Special Committee meeting held on the 30th, stating, "We will initiate a revolutionary change in medical school education and resident training, which are core to nurturing the future leaders of Korean healthcare but have lacked national support." He emphasized, "Above all, ending the low compensation for essential medical fields, which causes medical professionals in critical and essential areas to leave the field due to insufficient rewards, will be the starting point of reforms that the medical community also agrees on."

Cho Kyu-hong, Minister of Health and Welfare, said, "We will push for bold financial investment and legal and institutional improvements to ensure the smooth implementation of the medical reform plan," and requested, "We ask the medical community to actively participate in the Special Committee discussions."

Below is a Q&A with Minister Cho, Chair No, and officials from the Ministry of Health and Welfare.

- You mentioned establishing a supply-demand forecasting organization for medical reform this year. Is it possible to reconsider the increase in medical school admissions in 2026?

▲(Minister Cho Kyu-hong) Regarding the 2026 medical school quota, the government has already announced the university admission implementation plan, and it is necessary to consider that conditions are unlikely to change significantly in the short term. However, if the medical community agrees to use the forecasting adjustment system and proposes a reasonable alternative for the 2026 quota, discussions using this forecasting system are fully possible.

- The Korea Medical Association (KMA) is refusing to participate in the Medical Reform Special Committee and is demanding the formation of a separate discussion body. What is the government's position on the new consultative body requested by the KMA?

▲(Minister Cho) We have continuously requested participation in the Special Committee from the KMA, the Korean Academy of Medical Sciences, and resident groups, but there has been no response. We hope the medical community will promptly join the Medical Reform Special Committee discussions. If the medical community wishes, we can proceed with the Special Committee discussions while also conducting separate bilateral consultations.

- Do you expect that strengthening national support for resident training will serve as an incentive for residents to return?

▲(Chair No Yeonhong) The first medical reform implementation plan announced today actively reflects the demands residents have made, including establishing a supply-demand forecasting organization, legal responses to unavoidable medical accidents, improving resident training environments, and increasing specialist personnel. For 2025, about 400 billion KRW has been allocated for training-related budgets, including approximately 300 billion KRW to support supervising specialists. We will continuously strive to ensure practical improvements occur in training hospitals and other sites during next year's execution process.

- Given that the KMA and other physician organizations refuse to participate in the Medical Reform Special Committee, is it possible to secure 50% representation of physician occupational groups in the Physician Supply-Demand Forecasting Expert Committee?

▲(Jung Kyung-sil, Director of Medical Reform Promotion Team) The Supply-Demand Forecasting Expert Committee will be composed to ensure that more than half of the members are recommended by the medical community. We will request expert recommendations in September and expect active participation in recommending representatives from occupational groups.

- What is the current compensation level for low-compensation medical services such as severe cancer and emergency surgery follow-ups, and how much will the increase be?

▲(Director Jung) Representative low-compensation areas include surgeries for severe cancers such as brain cancer, head and neck cancer, and pancreatic cancer, along with associated anesthesia fees. Although compensation levels vary slightly by disease relative to costs, the average is about 85%. We aim to first raise the fees for highly complex severe surgeries and anesthesia frequently performed at tertiary hospitals to near cost levels. Specific levels and schedules will be announced after discussions at the Health Insurance Policy Deliberation Committee.

- If fees for severe cases increase, will patients' medical expenses also rise?

▲(Director Jung) Because there is a patient co-payment system linked to severe case fees, an increase in fees will basically increase patient co-payments. This mainly concerns severe cancer surgeries and associated anesthesia. Most patients in these categories are subject to special calculation exceptions, paying about 5-15% co-payment, which is relatively small. Additionally, there are several systems such as co-payment caps and catastrophic medical expense programs that reduce burdens, so patient co-payments will not necessarily rise proportionally with fee increases.

- What is the budget scale related to fee increases, and how do you plan to secure the budget?

▲(Lee Jung-gyu, Director of Health Insurance Policy Bureau, Ministry of Health and Welfare) Regarding essential medical care, about 10 trillion KRW will be invested over five years from health insurance finances. We judge this amount to be sufficient, and if additional funds are needed, more resources can be allocated. The budget forecast was made within the existing average insurance premium increase rate of 1.49%, and we believe stable financial management is possible within this range.

- The announced plan today seems to require cooperation from hospitals, doctors, and the medical community. How will you secure that cooperation?

▲(Director Jung) The announced measures focus on several key issues that the medical community is very interested in, such as fair compensation and medical accidents. The medical community recognizes these as very important systems, so we once again urge active feedback both within and outside the Medical Reform Special Committee and participation to ensure opinions are reflected during implementation.

- While the role and cooperation of the medical community are important, public participation is also crucial. How will you persuade, inform, and seek cooperation from the public?

▲(Director Jung) Especially for improving the medical delivery system, public cooperation is absolutely essential. Even if tertiary hospitals operate mainly for severe patients and regional emergency medical centers focus on severe emergency patients, if mild patients continue to use large hospitals or metropolitan hospitals instead of local clinics, improving the medical delivery system will be difficult. We will greatly increase the provision of information so consumers can better understand and choose medical institutions or professionals. At the same time, when mild patients use regional emergency medical centers or tertiary hospitals, we will partially redesign costs and institutionalize these measures.