EDITORIAL : THE KOREA HERALD, SOUTH KOREA

Patients held hostage

Doctors are threatening to stop treating patients in protest against the government’s plan to introduce a mandatory fixed-rate system for seven illnesses starting July 1.

Ophthalmologists have already declared they will not perform any cataract operations during the first week of next month, asserting that the new plan would cause a significant drop in the quality of their services. 

Obstetricians, orthopedic surgeons and otolaryngologists have also decided to temporarily stop conducting some of the six operations to be brought under the new pricing formula ― C-sections, hysterectomies, appendectomies, hernia operations, hemorrhoid surgery, and tonsillectomies.

The four groups of individually practicing doctors said they would announce their final stance on June 19. They are seeking to persuade their colleagues at general hospitals to participate in the collective action.

On the surface, the doctors oppose the government’s plan because it would make them unable to deliver enough care to their patients. The real reason is, however, that it would reduce their income. 

As such, the doctors’ protest is nothing more than a misguided attempt to hold patients hostage to protect their vested interests. Hence their unwarranted action should be met with stern punishment.

The Ministry of Health and Welfare has defined the doctors’ planned strike as illegal and made it clear that it would suspend the licenses of the physicians and hospitals that refuse to treat patients.

The doctors’ opposition to the ministry’s plan makes no sense, given that a fixed-rate pricing scheme has in fact been in place for a decade. In 2002, the ministry launched a “diagnosis-related group” payment plan, under which a uniform price was set for each of the seven above-cited surgical operations.

Although the system has been operated on a voluntary basis, more than 70 percent of the nation’s medical institutions are currently participating in it ― a fact that testifies to its viability. 

Based on the 10 years’ experience, the ministry now intends to make the DRG system compulsory for all hospitals ― first for clinics and small hospitals starting next month and then for large general hospitals a year later.

The primary merit of the DRG approach is that it can discourage doctors from providing unnecessary treatments to their patients. Under the current National Health Insurance system, doctors are paid for each service they offer to a patient. Hence they tend to increase the amount of care to maximize their income. The obvious problem with this tendency is that it drives up health care costs.

A fixed-price system compels doctors to reduce the volume of care because their hospitals can earn a profit only when they lower the cost of care below the uniform price.

For this reason, doctors argue that the DRG approach could lower the quality of medical services. But this argument is not based on evidence. A government study of the DRG system has found that it lowered medical costs by 14 percent without causing a significant drop in the quality of care.

Given the relentless upward spiral in health care costs in Korea, the fixed-rate pricing system should be implemented as planned. Physicians are strongly urged to give up their ill-advised strike attempt as it poses a grave threat to patients’ health. They should play a role in bringing down rising medical expenses.
(Dated-14/06/2012)