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[메디게이트뉴스 조운 기자] Contrary to the government’s call for medical reform, saying it will solve the open-run pediatrics program, the National Immunization Program (NIP) implementation fee, which is mainly implemented in pediatric clinics, has been found to have been frozen this year.
In particular, as the NIP implementation fee has increased by 1,610 won over the past 10 years, and private medical institutions have shouldered the loss, it is pointed out that it is only a matter of time before the department collapses as the number of residents increases along with the increase in the number of government medical school seats.
On the 20th, the Korean Association of Pediatricians made this statement, pointing out problems with the national vaccination implementation cost.
The National Immunization Program (NIP) implementation fee corresponds to the cost paid when a private medical institution administers government-designated vaccinations such as influenza, pneumococcus, tuberculosis, and rotavirus to patients.
This implementation cost includes not only the cost of the actions performed by doctors or medical staff, but also vaccine management costs and indirect costs, and is grossly undervalued to the point that it does not even reach the current cost level.
In fact, as a result of the cost analysis in the ‘Study on National Vaccination Cost Estimation’ published by the Korea Institute for Health and Social Affairs in 2018, six years ago, the NIP implementation cost was calculated to be 22,080 won on average, but the 2024 NIP implementation cost was frozen at 19,610 won.
It is known that even the implementation cost is not being paid for vaccinations in the second half of the year, with each local government using the excuse of exhausting the national vaccination operation budget, so it is not actually frozen but is being reduced.
The problem is that the Department of Pediatrics and Adolescents has a high proportion of health insurance patients, and in addition to general treatment, vaccinations account for a very large portion of the department.
Most vaccinations have been incorporated into the national vaccination system, and the Socheong Department handles most of the vaccines covered by the national vaccination program. However, due to the government’s neglect, the Socheong Department is on the path to decline.
According to data from the paper ‘The impact of decreased revenue of pediatric and adolescent clinics on business closure’ published by the research team of the Health Insurance Review and Assessment Service Review and Assessment Research Institute in 2024, pediatric clinics are the subject with the highest business closure rate between 2012 and 2022.
Sales levels and profits are also plummeting to a level that cannot be compared to other medical departments, and the report at the time also suggested, “If a medical treatment environment that guarantees stable profits is created, the closure of pediatric and adolescent clinics can be reduced.”
At the same time, the report said, “The government announced a plan to increase the national vaccination implementation fee and infant screening fees as part of the pediatric medical improvement plan in 2023,” and “Such government support measures will help stabilize the profits of pediatric and adolescent clinics.” Although he said, “It is expected that such support measures will be provided,” it is still dark news.
The Korean Medical Association said, “Since the government began full-scale national vaccination at private medical institutions in 2009, the Department of Pediatrics has been playing a key role in public health called ‘promoting public health through the prevention of infectious diseases.’ However, as the years go by, He explained, “The losses of private medical institutions through vaccination have inevitably increased, and the pediatric and adolescent departments are in a miserable decline due to the government’s indifference.”
The Medical Association said, “Although multivalent vaccines and combo vaccines are becoming more common and require expertise such as oral vaccination and intradermal vaccination, and the high rate of appeals and direct administration by doctors must be taken into consideration, the government is consistent in setting implementation costs uniformly.” He warned, “There is no guarantee that the current situation, where the vaccination rate is higher than that of other developed countries, can be maintained in the future.”
The Korean Medical Association said, “In December 2024, many pediatricians and young doctors dreaming of becoming a pediatrician will be wondering how the Korea Disease Control and Prevention Agency, the National Assembly, and the Ministry of Strategy and Finance will set the vaccination implementation cost this year, especially for children, as is the case for general pediatric treatment. “We will see whether the increase in vaccinations is achieved,” he said. “Support for residents (residents), which has fallen to the 10% level, will also end in December, and children’s vaccinations and pediatric “The key to reviving this shunned department, where the deficit increases the more it provides treatment, lies in the hands of the government and the National Assembly, so not only doctors but all citizens should pay close attention,” he said.
Here are two PAA related questions based on the interview transcript:
## Interview: The Future of Pediatrics in Korea – A Crisis Brewing?
**Host:** Welcome to World Today News. Today, we’re discussing a crucial issue affecting the healthcare landscape in Korea: the future of pediatric clinics. Joining us are Dr. Kim Sook-Hee, a leading pediatrician and representative of the Korean Association of Pediatricians, and Mr. Lee Joon-Ho, a health policy analyst at the Korea Institute for Health and Social Affairs. Thank you both for joining us.
**Section 1: The Frozen Implementation Fee**
**Host:** Dr. Kim, the article highlights the freezing of the National Immunization Program (NIP) implementation fee. Could you elaborate on the challenges this poses for pediatric clinics?
**Dr. Kim:** Certainly. The NIP fee is meant to compensate private clinics for administering government-designated vaccinations. However, this fee hasn’t kept pace with inflation for years. This means clinics are essentially losing money for every vaccination they provide. It’s creating a serious financial strain, especially for smaller clinics.
**Host:** Mr. Lee, from a policy perspective, what factors might have contributed to this decision to freeze the implementation fee?
**Mr. Lee:** That’s a complex question. While budgetary constraints are always a factor, there may also be misconceptions about the actual cost of administering vaccinations.
**Host:** Dr. Kim, do you believe the current implementation fee accurately reflects the true cost of providing these essential services?
**Dr. Kim:** Absolutely not. It doesn’t even factor in the expertise required for newer vaccines, like oral or intradermal administrations. Additionally, we handle a high volume of appeals and often have to directly administer vaccines to young children, requiring additional time and resources.
**Section 2: The Decline of Pediatric Departments and the Impact on Public Health**
**Host:** Mr. Lee, the article mentions a concerning trend of pediatric clinic closures. What are the broader implications of this decline for public health in Korea?
**Mr. Lee:** This is a critical issue. Pediatric clinics are at the frontline of preventing infectious diseases through vaccination programs. If their numbers continue to dwindle, we risk seeing a decline in vaccination coverage and potential outbreaks.
**Host:** Dr. Kim, how has the situation affected the morale and future prospects for pediatricians?
**Dr. Kim:** Frankly, it’s disheartening. Many young doctors hesitate to specialize in pediatrics because of the financial instability. This creates a worrying shortage of pediatricians.
**Host:** Mr. Lee, what steps can the government take to address this issue and ensure the sustainability of pediatric care in Korea?
**Mr. Lee:** Increasing the NIP implementation fee to a level that reflects actual costs is crucial. Additionally, providing targeted financial support to struggling pediatric clinics could help.
**Section 3: A Call for Action**
**Host:** Dr. Kim, what message would you like to convey to the government and the Korean public regarding the situation faced by pediatricians and the future of child healthcare?
**Dr. Kim:** This isn’t just about pediatricians; it’s about the health and well-being of our children. We need a serious commitment from the government to ensure that pediatric clinics are adequately supported so they can continue to play their vital role in safeguarding public health.
**Host:** Mr. Lee, how important is it for citizens to be involved in advocating for changes in healthcare policy?
**Mr. Lee:** Public awareness is crucial. When citizens understand the challenges faced by pediatricians and the potential consequences, they can put pressure on policymakers to prioritize these essential services.
**Host:** Thank you both for sharing your invaluable insights. This conversation highlights a crucial issue facing Korea’s healthcare system. We encourage our viewers to stay informed and engage in the discussion on how to ensure a healthy future for our children.
