Government announces reform of actual loss insurance system

[Anchor]

As the excessive non-covered medical treatments backed by actual loss insurance have grown uncontrollably, the government has taken action.

After more than 20 years since the introduction of actual loss insurance, the system will be completely overhauled, and improvement plans will be prepared by the end of this year.

Next, we have reporter Kim Ha-eun.

[Report]

There are over 2,200 hospitals across the country that specialize in non-covered treatments with no health insurance claims for an entire year.

Since there are no claims data, the government cannot know what treatments were provided and how many times.

The Special Medical Reform Committee sees understanding the current status of non-covered treatments as the first step in reforming actual loss insurance.

[Nam Eun-kyung/Special Medical Reform Committee: "Since only a very small number of items, not the entire non-covered treatments, are being assessed, it is necessary to first understand the overall status of non-covered treatments…."]

Non-covered treatments that have been recognized for their effectiveness after evaluation will be included in the National Health Insurance, and items that are deemed less essential may be considered for 'exclusion'.

[Jeong Hyeong-seon/Special Medical Reform Committee: "There is something called new medical technology assessment, and there are evaluations from the National Evidence-based Healthcare Collaborating Agency stating that dozens of non-covered treatments are not appropriate. Those could be included as items for exclusion."]

In particular, discussions are underway about applying National Health Insurance to certain non-covered treatments like manual therapy to control prices.

However, there are many challenges ahead.

The medical community is concerned about the contraction of non-covered treatments, while consumer groups are opposing the reduction of coverage in actual loss insurance.

[Jo Yeon-hyang/Chairman, Korea Finance Consumer Federation: "They are passing on to consumers the mistakes made in product creation and the improper application of the insurance system so far…."]

In conjunction with actual loss insurance, non-covered treatments have led to side effects such as excessive treatment.

The government plans to announce a medical reform plan containing measures for managing non-covered treatments around the end of the year.

This is KBS News, Kim Ha-eun.