Launch of Health Insurance Financial Reform Task Force ... "Reassessing Excessive Medical Use Such as MRI"

Ministry of Health and Welfare to Establish Detailed Plans for Health Insurance Expenditure Structure Reform by October

The Ministry of Health and Welfare is launching the Health Insurance Financial Reform Task Force to restructure the health insurance expenditure system.

The ministry announced on the 23rd that it held the first meeting of the "Health Insurance Financial Reform Task Force for Expanding Essential Medical Services," led by Lee Ki-il, the 2nd Vice Minister. The task force includes members from the Ministry of Health and Welfare, the National Health Insurance Service, and the Health Insurance Review and Assessment Service to identify tasks for improving health insurance finances.

The ministry pointed out that since the health insurance system was implemented in 1977, it has improved medical accessibility for the entire population and achieved significant results. However, recently, during the process of converting some non-covered items to covered benefits, there have been side effects such as a surge in the usage of certain items beyond expectations.

For example, the financial expenditure for brain and cerebrovascular magnetic resonance imaging (MRI), which has been covered by health insurance since October 2018, reached 252.9 billion KRW last year, exceeding the original target of 205.3 billion KRW with an execution rate of 123.2%. The expenditure for lower abdomen and urological ultrasound was 68.5 billion KRW, surpassing the annual target of 49.9 billion KRW, with an execution rate of 137.2%.

The task force plans to re-examine these existing covered items that are excessively used to check for any financial leakage and develop management measures. It will also investigate the phenomenon of excessive medical use, such as the increase in outpatients using services for more than 500 days annually, the rise in usage of non-covered and covered services like cataract surgery, and the relationship with private indemnity health insurance.

Cases of health insurance qualification misuse and improper use of the foreign dependent system will also be reviewed. The Ministry of Health and Welfare aims to develop a plan to reform the health insurance expenditure structure through the task force and strengthen essential medical services accordingly. The task force plans to conduct intensive discussions until October and announce detailed implementation plans.

Lee Ki-il, the 2nd Vice Minister of the Ministry of Health and Welfare, said, "The purpose of this task force is to maintain the current health insurance benefits received by the public while strengthening management of items with rapidly increasing financial expenditures and excessive medical use." He added, "We will ensure robust coverage in essential medical fields such as emergency and high-risk surgeries and childbirth to build a more trusted and sustainable health insurance system."

This content was produced with the assistance of AI translation services.