The NHI Trade Union says, 'NHIS should join the DREC'...

shortening the duration requires a careful verification

The government’s policy to strengthen patients’ access to new drugs is merely a response to corporate civil complaints

To reduce excessive treatment, ‘non-reimbursed treatments and reimbursed treatments should not be administered during a single visit’…the union criticized the policy for privatization

Kim Cheoljung, the chairman of the National Health Insurance Trade Union.

The National Health Insurance Trade Union has criticized the government’s ‘The Second Comprehensive Plan of National Health Insurance’ regarding measures to strengthen patients’ access to new drugs.

 

The union argued that the government formulated the policy referencing the corporate civil complaint.

 

And added, it would be more effective to include the National Health Insurance Service (NHIS) as part of the Drug Reimbursement Evaluation Committee (DREC).

 

During a press conference at the NHIS headquarters on the 26th, Kim Cheoljung, the chairman of the National Health Insurance Trade Union, stated this.

 

Kim maintained a critical standpoint when asked about the union’s stance on the details of the second comprehensive plan of National Health Insurance, which includes strengthening patients’ access to new drugs, reducing listing duration, and expediting the market entry of innovative medical instruments.

 

“The union regards ‘expediting the market entry of innovative medical instruments’ and ‘expanding the scope of the waiver system for new medical technology’ as merely corporate civil complaints and not the interests of the health insurance,” Kim explained.

 

According to the union, the government is pushing measures such as shortening the time it takes to list new drugs for health insurance from 330 days to 150 days via parallel processing of ‘approval-evaluation-negotiation,’ which is the process for drug reimbursement.

 

Additional measures include a comprehensive review and evaluation system to expedite the market entry of innovative medical instruments and an expansion of the waiver system for new medical technology.

 

“Terms like new drug accessibility, innovation, and new technology may sound nice, but the government must base its reimbursement decision on clinical effectiveness and cost-effectiveness, and not on implementing what corporates wish for their quick benefit,” Kim said.

 

The alternative would be to include the NHIS in the DREC of the Health Insurance Review and Assessment Service (HIRA).

 

“Recently, new high-priced drugs were primarily considered for health insurance reimbursement.

 

However, allowing reimbursement of those drugs that have not been evaluated for safety and cost-effectiveness may lead to a waste of finances, along with putting citizens as subjects of clinical experiment,” Kim said.

 

“The government has suggested processing reimbursement evaluation and drug pricing negotiations in parallel.

 

But, our opinion is that including the NHIS in the HIRA's DREC can shorten the duration and reflect on the NHIS’ stance regarding the cost-effectiveness of finances.” The union has strongly criticized the Yoon Suk Yeol government’s retrogressive policy.

 

The government did not release the National Health Insurance's annual insurance coverage cost to the public in 2022.

 

The government is limiting itself as an enforcement agency.

 

Rather than focusing on patient co-payment policy, such as strengthening cost coverage per income level, to aid citizens who cannot receive medical treatments because of the patient co-payment, The government is emphasizing the need for businesses to assist with catastrophic medical expenses, which can be perceived as a charity-like approach by the government.

 

“As an insurer, the government must enforce a policy to strengthen cost coverage or a separate business focusing on public function,” Kim said.

 

“Policies aimed at expanding health insurance big data sharing and legalizing non-face-to-face treatment can be characterized as privatization.

 

In response to the policy of expanding health insurance big data sharing, the union will collaborate with civil society for an action.

 

The union, along with the civil society, will boycott the NHIS’ meeting scheduled for the April 2,” Kim stressed.

 

The union said it will pursue ‘non-reimbursed treatments and reimbursed treatments should not be administered during a single visit’ to prevent national insurance loss.

 

"Every year, the burden of health insurance costs, personal insurance costs, and patient co-payments directly impact the citizens," Kim added.

 

"To address common practices in the medical field, such as recommending non-reimbursed treatments to patients seeking reimbursed treatment or providing unnecessary reimbursed treatments and billing them, as well as treating non-reimbursed instead of reimbursed practices, The union believes that 'mixed medical practices should be prohibited' now to eliminate these issues," Kim explained.

 

Regarding the recent conflicts between the medical community and the government over expanding medical school quotas, Kim expressed deep regret and emphasized the importance of having concrete plans for utilizing medical personnel stationed in regional areas.

 

"I feel really bad about the recent conflict regarding the 'expansion of the medical school enrollment quota,' Kim added.

 

"The biggest problem with this situation is that the government's policy of 'expanding the medical school enrollment quota' and the' doctors' strike' claim focus solely on 'money,' including medical insurance fees.

 

It is concerning that the government is not considering the well-being of citizens," Kim said.

 

“Of course, expanding the medical school enrollment quota is essential.

 

However, concrete plans should be made for the 'station and utilization of medical personnel' who will be responsible for the lives of citizens across the nation,” Kim emphasized.

 

The National Health Insurance Trade Union is affiliated with the Korean Public Service and Transport Workers’ Union (KPTU) under the Korean Confederation of Trade Unions (KCTU).

 

The union has a total of 13,842 members, with a membership rate of approximately 93%.

 

It consists of 13 headquarters, 267 branches, and 345 representatives.

 

The union expresses its opinion regarding the national health insurance policy as an insurer.

 

The union emphasizes the importance of expanding health insurance coverage and reducing citizens’ medical expenses.