Health insurance finance approved by the government alone

We need to think about national finance

Concerns about reducing the voting rights of health insurance subscribers, “Excessive government discretion”

Analysis of the 2022 Ministry of Health and Welfare Settlement by the Ministry of Budget and Policy

It was pointed out again that health insurance finance should be included in the national finance and operated as a fund.

 

There are concerns that if the health insurance finances are managed without going through deliberation by the National Assembly as it is now, transparency will be reduced and it can lead to negligence.

 

The current method of independently reviewing and approving health insurance finances by the Ministry of Health and Welfare has also been criticized for being excessively discretionary and reducing the authority of health insurance subscribers.

 

On the 10th, the National Assembly Budget Office announced this through an analysis of the Ministry of Health and Welfare’s financial statements for fiscal year 2022.

 

Currently, health insurance finance is being operated through the health insurance general account of the National Health Insurance Corporation.

 

The national pension, public servants pension, military pension, teacher pension, employment insurance, industrial accident compensation insurance, and long-term care insurance for the elderly are included in the national finance and operated as a fund.

 

The Ministry of Budget and Policy considered it a problem that decision-making on health insurance finances was made without external control by the Health Insurance Policy Deliberation Committee, which was established and operated under the Ministry of Health and Welfare, and the Ministry of Health and Welfare approved NHIS accounting, budget, and settlement.

 

It is unreasonable that the Ministry of Health and Welfare, which is the main body of health insurance policy establishment, has the right to review the budget and settlement of health insurance projects at the same time.

 

The Ministry of Budget and Policy said that it is necessary to strengthen the National Assembly's control over the health insurance finance managed outside of the national finance, and to strengthen the transparency and accountability of financial operations.

 

As a basis for this, it was said that national insurance premiums, which are the main financial source of health insurance finances, are in fact a quasi-tax, and that the government subsidizes a total of 20% of the expected income from health insurance premiums for that year, which causes limitations in figuring out the national fiscal balance.

 

It pointed out the problem that if the increase in health insurance fiscal expenditure is not properly controlled, subscribers and the general public who pay insurance premiums and taxes will cover the cost.

 

In particular, the National Fiscal Management Plan includes only a portion of the health insurance budget, which underestimates the scale of health and welfare expenditures and limits the ability to accurately grasp the actual total national expenditure.

 

In addition, it was criticized that the health insurance policyholders' voting rights were not sufficiently guaranteed as the Ministry of Health and Welfare could take the lead in making decisions on major agendas related to health insurance finance input through a separate advisory meeting without deliberation and resolution by the Health Policy Deliberation Committee.

 

During the deliberation on the calculation of the amount of compensation for losses in the medical sector caused by the promotion of reimbursement for ultrasound and MRI examinations, there were also cases where the Ministry of Health and Welfare did not provide enough data necessary for deliberation, such as reporting to the Health Policy Deliberation Committee on reduced profits in the medical sector.

 

In response, the Ministry of Budget and Policy ordered the establishment of a health insurance fund, reconsideration of transparency in financial operations such as health insurance expenditure and income, and concrete measures to strengthen democratic control of the National Assembly, taking into account the characteristics and conditions of health insurance finances and the lack of a control function.

 

The Ministry of Budget and Policy explained, “If the health insurance finance is operated as a fund, it is possible to operate it flexibly compared to the budget so that it can respond appropriately to the characteristics of short-term insurance.” Next, the Office of Budget and Policy pointed out, "Political issues in the National Assembly basically conform to the principle of representative democracy.

 

The current decision-making structure rather exaggerates the scope of the government's discretion." “Expanding health insurance coverage and securing financial soundness is the premise and goal of health insurance finance operation, and the criticism that the expansion of coverage is hindered when funded is insufficiently grounded in logic,” he said.