Fight over saving the budget for public hospitals begins

Posted on : 2009-12-14 12:42 KST Modified on : 2019-10-19 20:29 KST
Analysts say Lee administration is making further cuts when S. Korea already ranks well below the OECD average on health spending
 while the lower line shows the ratio of public hospitals to the total number of medical institutes established in South Korea.
while the lower line shows the ratio of public hospitals to the total number of medical institutes established in South Korea.

Mr. Kim, a 53-year-old basic livelihood subsidy recipient, was sitting last Friday in a six-person hospital room at the Samcheok Medical Center located in Samcheok, Gangwon Province. In addition to a lower back injury caused ten years ago by falling out of a tree, he subsequently suffered a traffic accident and has had three operations on his spine alone. Since his wife’s death from cancer a few years ago, he has had no one to look after him.

About three weeks ago, Mr. Kim felt a severe pain in his back and went to visit a private hospital located near his home. He was soon forced to go elsewhere. “When I said I was a Medicaid beneficiary, they would not admit me and made all kinds of excuses, like ‘Return in the afternoon’ and ‘Our beds are all filled up,’” he recalled. “It truly is a scary, sad world,” he sighed.

With a bitter smile, Kim added, “If it were not for places like this, people like me would have nowhere to go when they are suffering.”

For patients in low-income brackets like Mr. Kim, public hospitals such as the 34 local medical centers located in 13 cities and provinces nationwide and the six Red Cross hospitals have become a major place of refuge. Private hospitals that place a high value on immediate profits do not allow the free provision of treatments that are not covered by Medicaid and regard Medicaid patients as more burdensome than those with health insurance because they pay less in fees. Indeed, statistics from the Ministry for Health, Welfare and Family Affairs show that Medicaid patients account for 41.8 percent of all patients admitted to local medical centers, over three times the 13.2 percent admitted to private hospitals.

Public hospitals are a welcome presence for the working class as well. Not only is admission easier, but because they only carry out the treatment that is absolutely necessary and do not add on items that are not covered by their health care plan, the treatment costs come out to 65 to 88 percent of those at private hospitals.

As of next year, however, patients like Mr. Kim will have a harder time feeling assured that they will able to receive proper medical treatment. The Lee administration has nearly halved its support budget for regional public hospitals and local medical centers. The 2010 budget allocated by the administration for this area is 25.912 billion Won, a 42 percent drop from the original 2009 budget of 44.818 billion Won (53.918 billion Won with the supplementary budget). The 3.4 billion Won “hospitals without guardians” budget, which the Welfare Ministry sought to introduce in order to promote the competitiveness of local medical centers, was completely cut during the course of discussions that took place within the Ministry of Strategy and Finance.

Fortunately, the National Assembly’s Health, Welfare and Family Affairs Committee increased the support budget for public hospitals to 61.1 billion Won, citing “many problems” with the administration’s budget plan. However, analysts say it remains to be seen whether this will pass through the Special Committee on Budget and Accounts where budgets that have been increased through the Assembly’s standing committees are frequently slashed.

Local medical centers are already in poor shape. More and more they are unable to perform their proper function because of chronic red ink, aging physical facilities and equipment, and difficulties securing medical staff. Last year, 29 of the 34 local medical centers were in the red by as much as 41.4 billion Won. The total deficit was more than 500 billion Won. Samcheok Medical Center Director Park Chan-byeong said, “The administration is making the unreasonable demand that we maintain our public character, but generate a profit without any systematic support.” Park added, “It has gotten to the point where it has been difficult to pay employees their wages.”

The Samcheok Medical Center has eliminated its delivery room due to the cost of maintaining equipment and a lack of space, and it has had to abandon its dream of replacing its antiquated gastroscopy equipment next year. In the aging Uijeongbu Medical Center in Gyeonggi Province, rain leaks into some of the hospital rooms and the sill of the isolation ward bathroom is too high for wheelchairs to pass. The Gangneung Medical Center in Gangwon Province does not even have a patients’ elevator.

Lee Ju-ho, head of the Korea Health and Medical Workers’ Union strategy and planning team said, “These stubborn budget cuts are the administration’s way of saying that it wants to abandon public health services.”

Lee Won-young, professor of preventive medicine at Chung-Ang University said, “Public hospitals accounts for approximately 11 percent of the total in terms of numbers of hospital beds in South Korea and the quantity as well as quality of the services are poor in comparison with the OECD average at 80 percent.”

Professor Lee added, “The administration needs to take a close look at the public hospital situation and focus on building up a social safety net.”

In response, a Welfare Ministry official said, “It seems as though these cuts came as a result of the overall poor financial economic situation facing the country.” The official added, “Since the government also knows how serious the public health services situation is, it will be establishing a direction for improvements and work on securing a budget,”

Please direct questions or comments to [englishhani@hani.co.kr]

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