While the increase is likely due to the accumulated deficit ahead of the adjustment of insurance pre..

While the increase is likely due to the accumulated deficit ahead of the adjustment of insurance premiums at the end of this year, the reform plan for real-life insurance to reduce over-treatment of non-payment subjects such as manual treatment but strengthen public medical care is slow.

According to the insurance industry on the 5th, health authorities are discussing the establishment of a “non-payment management policy consultative body” to discuss with the medical community to strengthen management by designating non-benefit such as manual treatment as management benefits. We recently had two meetings and plan to continue the meeting at the end of this month.

However, it has not yet been determined in detail what topics will be discussed as the main agenda of the meeting. As a result, as the medical community decides whether to participate or not depending on the topic of the meeting, discussions on the promotion of reforms through the consultative body may be slow. Currently, the medical community still maintains that it is “in principle impossible” to strengthen management by designating non-payment treatment subjects such as manual treatment as management benefits.

Lee Tae-yeon, vice chairman of the Korean Medical Association, said, “There is a need for medical treatment for seriously ill patients, and if non-benefit treatment is designated as a salary and managed, there may be restrictions on patients receiving treatment.” “There is no agenda or details for the meeting yet,” he said.

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Loss of KRW 1-2 trillion every year due to excessive medical treatment of real loss insurance

Earlier this year, the authorities announced a reform plan for real loss insurance. The main point of the real loss insurance reform plan is to increase the burden of patients with non-benefit medical treatment such as manual treatment from the current 20% level to 90-95%, but to expand the coverage of severely ill patients. Currently, non-paying medical treatment is not covered by health insurance benefits, so patients are paying the full amount of medical expenses, and the majority of patients are covered by real loss insurance.

However, the authorities believe that even if the patient’s self-burden increases, if management is strengthened, the medical price itself will be lowered, reducing the patient’s burden. Currently, medical institutions can set the appropriate price and number of treatments for non-payment subjects on their own, so management is necessary as there are large variations in price and frequency.

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Authorities believe that strengthening non-payment management will have the effect of easing insurance premiums for real loss insurance. This is because there is room for a reduction in insurance premiums as unnecessary non-payment treatment has been reduced due to strengthened management. Due to losses of 1 to 2 trillion won per year, it is inevitable to raise the premium loss insurance rate every year when setting the premium loss insurance rate.

An industry official said, “In addition to the accumulated deficit, loss insurance is difficult to cover due to excessive treatment every year,” adding, “It is necessary to prevent over-treatment of non-payment treatment, not essential treatment, and the authorities are discussing related matters.”

Meanwhile, the authorities held a “policy discussion on non-payment management and real-life insurance reform plan” in January to designate non-payment items such as manual treatment as management benefits and are pushing for reforms linked to real-life insurance while reducing the scope of non-payment coverage.