Injecting 10 Trillion Won into Health Insurance for Tertiary Hospital Structural Reform
ICU Admission Fees Also Increased by 50%
The government will increase the fees for surgeries involving severe cancers such as head and neck cancer, gastrointestinal cancer, as well as complex surgeries like heart and cerebrovascular operations by 50%. Including this, approximately 10 trillion won of health insurance funds will be invested over three years in a project to restructure tertiary general hospitals so they can focus on treating severe and emergency patients.
Jeong Gyeong-sil, Director of the Medical Reform Promotion Team at the Ministry of Health and Welfare, is announcing the 'Plan to Promote the Support Project for the Structural Transformation of Tertiary Hospitals' on the 27th at the Government Seoul Office in Jongno-gu, Seoul. [Photo by Ministry of Health and Welfare]
The "Tertiary General Hospital Structural Transformation Support Project Promotion Plan," announced on the 27th by the Presidential Commission on Medical Reform, focuses on transforming tertiary general hospitals into "critical care-centered hospitals." This follows criticism that tertiary general hospitals, which should concentrate on severe, emergency, and rare disease patients, have been treating many mild cases and overly relying on residents.
To this end, the number of general beds in tertiary general hospitals will be reduced by 5-15% to focus on treating severe, emergency, and rare disease patients, and fees for 910 surgeries including cancer, heart, and cerebrovascular surgeries, as well as anesthesia fees, will be increased by about 50%. Intensive care units will receive an additional 300,000 won per day, which is 50% of the current fee, and fees for 2-4 person rooms will also receive an additional 75,000 won per day, 50% of the current fee. The medical staff at tertiary general hospitals will be reorganized to focus on specialists and physician assistants (PAs) to reduce excessive dependence on residents, allowing residents to concentrate more on their primary training duties.
This project, targeting 47 tertiary general hospitals, will inject 3.3 trillion won annually, totaling 10 trillion won in health insurance funds over three years. This is a separate initiative from the government's previously announced 20 trillion won essential and regional medical support plan over five years, announced last August.
In particular, the government plans to provide additional incentives totaling over 1 trillion won to hospitals that reduce general beds and increase the proportion of severe patients beyond a certain level. The extent to which specialists and nurses have been expanded to reduce dependence on residents, as well as improvements in the resident training environment, will also be included in hospital performance evaluations.
However, the government has stated that even if these measures are implemented, patient co-payments will not increase during emergency treatment periods. Regarding concerns that fee increases could cause deficits amid the current emergency treatment system, which already costs 200 billion won monthly from health insurance funds, the government explained that "(current health insurance) resources are stable."
Nonetheless, medical associations have criticized the government's plan as a "stopgap measure" aimed at immediately reducing patient numbers. The Korean Medical Association stated in a press release, "This policy lacks realism and does not consider the problems that may arise in actual medical settings," and added, "Creating tertiary general hospitals centered on specialists and PA nurses without solutions for next year's specialist output, especially when residents who have left the medical field have not returned, forgets the fundamental functions."
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