Kang Jung-gu, President of HIRA, "Essential Medical Care Damaged Over 20 Years... Resolving Issues Like Fees Is Urgent"

Kang Jung-gu, President of the Health Insurance Review and Assessment Service
"Even if doctors increase, it takes 10 years with study and training"
"We must solve current issues with a long-term perspective"

Calls for fee reform reflecting surgery and procedure difficulty, severity
Also addressing resident workforce shortage

Kang Jung-gu, the president of the Health Insurance Review and Assessment Service (HIRA) and a former surgeon, emphasized that increasing the number of medical students alone cannot solve the immediate problems, and that addressing current medical issues such as fee imbalances is essential to resolving the challenges in essential medical care.

Kang Jung-gu, President of the Health Insurance Review and Assessment Service
Photo by Health Insurance Review and Assessment Service

On the afternoon of the 21st, at a luncheon meeting with the Ministry of Health and Welfare press corps held in Seocho-gu, Seoul, President Kang stated, "Simply increasing the number of doctors does not solve everything; interns and medical students must be directed toward essential medical fields," adding, "Since it requires six years of study and four years of training, the government must think long-term and quickly resolve the current issues."

Regarding the current collapse of essential medical care, Kang said, "This did not deteriorate overnight but has worsened over 20 years due to issues with fees, legal problems, and the lack of replacement personnel for residents," emphasizing, "Because the relative value score system has been in operation for 20 years, important essential medical specialties have deteriorated," identifying the relative value system as an urgent core reform task.

The relative value system currently forms the basis of the National Health Insurance fee system. It determines fees by assigning scores through relative evaluation of the workload, medical fees, and risk associated with medical procedures. Workload is calculated based on the physician's procedure time, medical fees include labor, material, and equipment costs, and risk is scored based on medical malpractice costs.

President Kang explained the current system by saying, "The costs have not been properly evaluated," and that "the biggest complaint from doctors is that the physician workload is undervalued." Despite the existence of various surgeries and procedures, their diversity is not recognized and is uniformly converted based on time, which is problematic. Additionally, since severity and risk costs need to be reflected, Kang stated, "We will research how to change this and set new standards."

Regarding the restriction of residents' maximum weekly working hours to 80, he noted, "As the number of residents decreased, the workload became harder, and staff began quitting," adding, "Replacement personnel must be created to cover the shortage, and the government must actively address this."

Meanwhile, marking eight months since his recent appointment, President Kang evaluated, "Although HIRA has strived to provide better medical services, especially through this national audit, we were able to reconsider HIRA's role from a more objective and critical perspective," continuing with concerns and measures regarding financial leakage due to the policy of strengthening coverage, and the direction essential medical policies should take.

He also said, "We will work to improve efficiency in claims review through revising review standards and strengthening computerized review, as well as advancing the review system to optimize financial expenditures," and added, "We will verify and review whether there is any waste in health insurance finances through reevaluation of benefit items."

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