[국감 이슈] National Health Insurance Corporation and HIRA, a doctor-turned-director… Searching for solutions to medical reform

[세종=뉴스핌] Reporter Shin Do-kyung = In the government audit held on the 16th for the National Health Insurance Corporation (NHIS) and the Health Insurance Review and Assessment Service (HIRA), questions are expected to continue on health insurance finances and prospects for medical reform due to collective action by doctors.

The National Assembly Health and Welfare Committee holds a National Assembly audit for the Corporation and HIRA, which are agencies under the Ministry of Health and Welfare.

◆ Chairman of the National Health Insurance Corporation, Chairman of the Health Insurance Review and Assessment Service, and head of the institution who was a doctor… Intensive verification of medical field outlook

The Welfare Committee is expected to continue questioning the Corporation’s Chairman Jeong Ki-seok and HIRA President Kang Jung-gu about the medical field and medical reform resulting from the doctors’ group action that has continued for nine months. This is because both Chairman Jeong and Director Kang have experience in the medical field as doctors.

Chairman Jeong is a doctor of medicine from Seoul National University Graduate School. He served as a professor of respiratory allergy at Hallym University Sacred Heart Hospital and then served as the hospital director. Director Kang is a doctor of medicine from Yonsei University Graduate School. After working as a professor of surgery, he served as the director of Cha Ilsan Medical Center.

The Welfare Committee is expected to ask the heads of the two institutions for their opinions on the scale of medical school expansion. The government plans to ask for opinions on whether the 2,000 students to be added to medical schools next year is appropriate for medical fields and on distribution plans.

[서울=뉴스핌] Reporter Lee Hyeong-seok = On the morning of the 7th, the Health and Welfare Committee’s audit of the Ministry of Health and Welfare and the Korea Disease Control and Prevention Agency is being held at the National Assembly in Yeouido, Seoul. 2024.10.07 leehs@newspim.com

In addition, the Welfare Committee plans to inquire about the health insurance finances managed by the corporation. The Ministry of Health and Welfare announced that it would invest 10 trillion won + alpha (α) in national health insurance funds over the next five years for medical reform. However, according to estimates by the Ministry of Health and Welfare, health insurance funds will be depleted in the early 2030s. In a situation where National Health Insurance funds are insufficient, it is expected that there will be questions about the appropriateness of the amount of finance invested for medical reform and ways to expand National Health Insurance finances.

Meanwhile, HIRA is an organization that reviews medical expenses and evaluates the quality of medical care for medical institutions. The Welfare Committee plans to ask questions about measures to address excessive medical use, strengthening compensation for essential medical services, and the prospects for reforming the relative value score.

◆ Corporation employees investigated 22 people over 5 years… A total of 30 disciplinary actions this year

The Welfare Committee also plans to question Chairman Jeong about internal misconduct. According to Rep. Kim Mi-ae’s office, the number of disciplinary actions received by National Health Insurance Corporation employees from 2019 to the end of September this year was 139. Of these, 22 cases, or 16.1%, were investigated by investigative agencies such as prosecutors and police.

According to the investigation, the most common case was five cases of violation of the National Health Insurance Act. They ranged from special injuries, bribery, improper solicitation, assault on drivers, and concealment of criminal proceeds. A total of 30 disciplinary actions occurred this year. These ranged from sexual harassment, harassment at work, and access to personal information.

The issue of the corporation’s internal misconduct was pointed out by the National Assembly Budget Office not only this year but also last year. A total of 148 employees were disciplined from 2018 to July 2023, and it was pointed out that personnel management of executives and employees should be strengthened considering the high level of ethical awareness and social responsibility required of executives and employees of public institutions.

The Welfare Committee is expected to inquire as to why the corporation’s misconduct continues despite being criticized by the National Assembly for internal misconduct last year. In addition, calls for measures to reduce internal misconduct are expected to be made.

sdk1991@newspim.com