Probability of inclusion of screening such as excessive medical non-payment management reinforcement manual therapy ↑
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There is still opposition from the medical community to the non-payment management plan, which designates non-payment treatment subjects such as manual treatment as management benefits. Health authorities believe that even if the patient’s self-burden rises to 95%, the burden on patients will be lowered due to lower medical fees, but the medical community is concerned that patients’ options will be greatly reduced.
According to health authorities on the 2nd, the medical community recently objected to the management plan at a press conference at the Spring Conference of the Korean Society of Shock Wave Regenerative Medicine. In other words, it may be difficult to treat non-paying medical subjects that have been performed in hospitals. In addition, the medical community believes that non-payment treatment subjects should not be managed with management benefits, but that loss itself should be checked for large leaks of loss insurance.
Lee Tae-yeon, chairman of the Korea Medical Association’s Real Loss Insurance Countermeasures Committee, said, “There are patients who really need non-payment treatment (if non-payment is made into administrative benefits), and we have no choice but to reduce non-payment treatment because the price such as labor costs is not appropriate.”
However, although it has not yet been decided which medical subjects will be administered, manual therapy with high medical frequency and extracorporeal shock waves are being discussed as priorities. Even if it is the same manual treatment, it is also being considered to distinguish it according to the diagnosis code and designate it as a management benefit.
Previously, the authorities believed that improvement was necessary only for excessive medical treatment such as manual treatment. Currently, there are no restrictions on the number and price of non-payment treatment, so medical institutions set themselves autonomously, so the price of treatment varies widely from hospital to hospital. Therefore, it was considered that management was necessary to strengthen public medical care.
An official from the authorities said, “It is necessary to improve the medical treatment subject, which is not an essential non-payment treatment subject, but an excessive treatment. As there is no specific decision yet, we will continue to discuss the medical fee and the medical treatment subject.”
Another reason for the reform is the deterioration of the loss ratio, such as the increasing loss of real-life insurance. Last year’s loss insurance-related deficit, recently announced by the Financial Supervisory Service, recorded 1.62 trillion won.
According to the insurance money paid last year, non-benefit injections (nutritional supplements, etc.) were 2.8 trillion won, and musculoskeletal diseases (such as water treatment) were 2.6 trillion won. It was pointed out that 35.8% of the total insurance payments were made, causing unnecessary over-treatment.
In addition, there are voices calling for the right to survive over the management plan. The Korea Association of Physiotherapists is suggesting that if the patient’s self-burden increases, the patient’s utilization rate may eventually fall, threatening the survival rights of physiotherapists nationwide.
Meanwhile, the authorities plan to discuss through the ‘non-payment management policy consultative body’ involving the medical community, patients, consumer groups, and experts. We will discuss medical treatment and medical fees to be included as management benefits.
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