NHIS and Medical Associations Begin Fee Negotiations: "Deficit Inevitable" vs. "Urgent Need for Realignment"

2027 Medical Care Benefits Fee Contract Joint Meeting

The National Health Insurance Service (NHIS) and medical associations have officially kicked off the first round of negotiations for the 2027 medical fee schedule. While the NHIS has underscored the importance of fiscal soundness, stating that a large-scale financial deficit is inevitable from this year due to the insurance premium rate approaching the legal ceiling, the medical associations have called for a significant increase, arguing that current low medical fees do not even cover rising costs in goods and labor.

Jung Ki-seok, Chairman of the National Health Insurance Service (fourth from the left in photo), and Kim Taek-woo, President of the Korean Medical Association (third from the left), along with other medical organization leaders, are taking a commemorative photo at the "2027 Nursing Benefit Cost Contract - Chairman and Medical Organization Leaders Joint Meeting" held at Seoul Garden Hotel in Mapo-gu, Seoul on the 7th. National Health Insurance Service

Photo by National Health Insurance Service

On May 7, the NHIS held the "2027 Medical Care Benefits Fee Contract Chairmen-Medical Association Presidents Joint Meeting" at the Seoul Garden Hotel in Mapo-gu, Seoul, with Chairman Jung Ki-seok, Kim Taek-woo, President of the Korean Medical Association, Yoo Kyung-ha, President of the Korean Hospital Association, Lee Jeong-woo, Acting President of the Korean Dental Association, Yoon Sung-chan, President of the Association of Korean Medicine, Kwon Young-hee, President of the Korean Pharmaceutical Association, and Lee Soon-ok, President of the Korean Midwives Association, all in attendance.

Chairman Jung Ki-seok stated, "As Korea enters a super-aged society, we are seeing a sharp rise in medical expenses. At the same time, we have started making large-scale investments in the health insurance fund to strengthen regional, essential, and public healthcare, as well as to restructure tertiary general hospitals for a better healthcare delivery system. However, with the current premium rate at 7.19%, nearly reaching the legal cap of 8%, it is not easy to secure additional revenue sources. Thus, from this year, a significant financial deficit is inevitable."

Chairman Jung continued, "Now more than ever, it is critical for subscribers, providers, and the insurer to all make concerted efforts to manage finances. While maintaining the medical infrastructure so that the public can access necessary care, the negotiations must also strike a balance between the economic burden on citizens—stemming from high oil prices, inflation, and exchange rates due to the Middle East conflict—and the long-term sustainability of the health insurance fund."

The heads of medical associations all demanded a substantial increase in medical fees. Kim Taek-woo, President of the Korean Medical Association, said, "Last year's negotiations ended with a disastrous outcome, with the increase rate failing to keep up with inflation. This year, more support is needed to ensure the stable operation of medical institutions." He added, "In the event of failed negotiations, instead of penalties, rights such as the right to strike should be guaranteed."

Yoo Kyung-ha, President of the Korean Hospital Association, argued, "Hospitals are facing an extremely challenging environment due to rising prices, labor costs, and various operating expenses. With such low compensation rates, it is difficult to even secure specialized personnel. If government policy is to yield real results, the reimbursement system must be adjusted to support these policies."

Kwon Young-hee, President of the Korean Pharmaceutical Association, stated, "The chronic shortage and supply instability of prescription drugs, which has persisted for years, has reached a point where it can no longer be addressed by the efforts of pharmacies alone. This round of negotiations should go beyond simply setting this year’s reimbursement level—it must serve as an opportunity to adequately reflect the difficulties faced by pharmacies. Through this, I hope that pharmacies can secure the minimum resources needed to fulfill their role as essential healthcare providers for the public."

Starting with this meeting, the NHIS will enter into full-scale negotiations with medical associations. According to the National Health Insurance Act, once the rate of increase is determined, each association must sign a medical care benefits fee contract with the NHIS by May 31.

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