ê°€ìž…ìž 4%ê°€ 보험금 65% ìˆ˜ë ¹â€¦ì† í•´ìœ¨ ëˆˆë ©ì ´[실손 대수술ⓛ]

ì‹¤ì† ë³´í—˜ ê°€ìž…ìž 4.4%ê°€ 보험금 65% 받아

비급여 관리 안 되는 탓…실손 손해율 126%

ì „ì²´ ê°€ìž…ìž ë³´í—˜ë£Œ 높여…êµë¯¼ë³´í—˜ì— ë „ ì•…ì˜ í–¥

[서울=뉴시스] ë‚¨ì •í˜„ ê¸°ìž = ì ¼ë¶€ ì‹¤ì† ë³´í—˜ ê°€ìž…ìž ë“¤ì ´ 보험금 ëŒ€ë¶ €ë¶„ì „ ìˆ˜ë ¹í•˜ëŠ” ìƒ í™©ì ¸ë °, ê·¸ ì› ì ¸ìœ¼ë¡œ 비급여 ê´€ë¦¬ì ˜ ì–´ë ¤ì›€ì ´ ì§€ëª©ë œë‹¤. ì ´ëŠ” ì ˜ë£Œê¸°ê´€ì— ì„œ ìž„ì ˜ë¡œ 비급여 ê°€ê²©ì „ ì •í• ìˆ˜ 있기 ë•Œë¬¸ì ´ë‹¤. ì ´ì— ë³´í—˜ë£Œ ì‚°ì •ì ˜ ê¸°ì¤€ì ´ ë ˜ëŠ” ì‹¤ì† ë³´í—˜ ì† í•´ìœ¨ì ´ 130%대를 육박하는 ìƒ í™©ì ´ë‹¤.

23ì ¼ ë³´í—˜ì—…ê³„ì— ë”°ë¥´ë©´ 삼성화재, í˜„ëŒ€í•´ìƒ , 메리 ì¸ í™”ìž¬, KBì† ë³´ 등 4ê°œ ì† ë³´ì‚¬ì ˜ ìƒ ë°˜ê¸° ì‹¤ì† ë³´í—˜ ì²êµ¬ í˜„í™©ì— ë”°ë¥´ë©´ ê°€ìž…ìž ì ˜ 4.4%ê°€ ì „ì²´ 보험금( 3ì¡°8379ì–µì› )ì ˜ 65%(2ì¡°4671ì–µì› )ì „ ìˆ˜ë ¹í•œ 것으로 나타났다.

ì ¼ë¶€ ë³´í—˜ê°€ìž…ìž ë“¤ì ´ ‘ë³´í—˜ ì‡¼í•”ì „ 하면서 ì„ ëŸ‰í•œ ì „ì²´ ë³´í—˜ê°€ìž…ìž ì ˜ 보험료가 ë ™ë°˜ ìƒ ìŠ¹í•œ ë¶€ìž’ìš©ì ´ ë°œìƒ í•˜ê³ ìžˆëŠ” ê²ƒì ´ë‹¤.

ì ´ëŠ” 비급여 ë³´í—˜ê¸ˆì ´ ê´€ë¦¬ë ˜ì§€ ëª»í•˜ê³ ìžˆëŠ” íƒ“ì ´ë‹¤. ê±´ê°•ë³´í—˜ 급여와 달리 비급여는 ì‚¬ì‹¤ìƒ ‘ì ˜ë£Œê¸ °ê´€ì ˜ ìž ìœ¨ ì˜ ì—’ì ´ë‹¤. ì‹ ì ˜ë£Œê¸°ìˆ í ‰ê°€ì— ë”°ë ¼ ì‹ ì ˜ë£Œê¸°ìˆ ë¡œ ì ¸ì •ë§Œ ë ˜ë©´ ì ˜ë £Œê¸°ê´€ë“¤ì € 비급여 진료 횟수와 ê°€ê²©ì „ ìž„ì ˜ë¡œ ì •í• ìˆ˜ 있기 ë•Œë¬¸ì ´ë‹¤.

ì ´ì— ë¹„ê¸‰ì—¬ 과잉 ì²êµ¬ ë¬¸ì œëŠ” í•œ í•ëª©ì ´ 잡히면 새로운 í•ëª©ì— ëŒ€í• œ ì²êµ¬ê°€ 새ë¡ê²Œ ì¦ ê°€í•˜ëŠ” ì–’ìƒ ì „ ë³´ì ´ë©° ê³µíšŒì „ì „ ê±°ë“í•˜ê³ ìžˆë‹¤.

예컨대 백내장 다초ì ë Œì¦ˆ ìˆ˜ìˆ ì— ëŒ€í•œ ì§€ê¸‰ë³´í—˜ê¸ˆì € 2018ë…„ 2552ì–µì› , 2019ë…„ 4300ì–µì› , 2020ë…„ 6480ì–µì› , 2021ë…„ 9514ì–µì› ë“±ìœ¼ë¡œ 꾸준히 ì¦ ê°€í–ˆì§€ë§Œ 2022ë…„ ëŒ€ë²•ì› ì ˜ íŒ ê² °ë¡œ ìž…ì› ë³´í—˜ê¸ˆ ìˆ˜ë ¹ì ´ ì–´ë ¤ì›Œì§€ìž ì§€ë‚œí•´ 903ì–µì› ê¹Œì§€ ìª¼ê·¸ë ¼ë“¤ì—ˆë‹¤.

하지만 ê°™ì € 기간 비타민주사 등 ë¹„ê¸‰ì—¬ì£¼ì‚¬ì œ ì §€ê¸‰ë³´í—˜ê¸ˆì € 2018ë…„ 1979ì–µì› , 2019ë…„ 2636ì–µì› , 2020ë…„ 3321ì–µì› , 2021ë…„ 3498ì–µì› , 2022ë…„ 4104ì–µì› , 지난해 6334ì–µì› ë“±ìœ¼ë¡œ 꾸준히 ìƒ ìŠ¹í –ˆë‹¤. 5ë…„ 새 220.1% ê¸‰ì¦ í–ˆë‹¤.

ë³´í—˜ì—°êµ¬ì› ì¡°ì‚¬ì— ë”°ë¥´ë©´ 지난해 ì† í•´ë³´í—˜ì‚¬ 지급보험금 11ì¡°9000ì–µì› ì¤’ 10대 비급여(3ì¡°7000ì–µì› )는 31%를 차지하는 것으로 ì¶”ì •ë 다.

ê·¸ ê²°ê³¼ ì‹¤ì† ë³´í—˜ ì† í•´ìœ¨ì € ìƒ í–¥ ê³¡ì„ ì „ ê·¸ë¦¬ê³ ìžˆë‹¤. 지난해 1분기 ì‹¤ì† ë³´í—˜ ì† í•´ìœ¨ì € 119.4%ì— ì„œ 올해 1ë¶„ê ¸° 126.1%ë¡œ 6.7%í ¬ì ¸íŠ¸ ì•…í™”ë 다. ì† í•´ìœ¨ì € ë°›ì € 보험료 대비 지급한 ë³´í—˜ê¸ˆì ˜ ë¹„ìœ¨ë¡ œ, ì‚°ìˆ ì 으로 100%를 ì´ˆê³¼í• ê²½ìš° 보험사가 ì ìž ë¥¼ 본다는 ì ˜ë¯¸ë‹¤.

비급여 ì§„ë£Œì ˜ 과잉 공급, ë „ë •ì í•´ì ´ 등과 ê´€ë ¨í•œ ë ” í ° 문 ì œì ì € êµë¯¼ê±´ê°•ë³´í—˜ì ˜ ì§€ì† ê°€ëŠ¥ì„±ê¹Œì§€ ì €í•´í• ìˆ˜ 있다는 ì ì ´ë‹¤.

ë „ìˆ˜ì¹˜ë£Œ 등 비급여 물리치료 ì‹œ ê¸‰ì—¬ì ¸ 진찰료 , 재활·물리치료료 ë³’í–‰ì ´ ë°œìƒ í•˜ëŠ”ë °, 2021ë…„ 기준 외래 ìž¬ì§„ì— ì„œ ë „ìˆ˜ì¹˜ë£Œ 볒행진료로 ì§€ì¶œë œ ê³µë‹¨ë¶€ë‹´ê¸ˆì € 1513ì–µì› ì— ë‹¬í•œë‹¤.

êµë¯¼ê±´ê°•ë³´í—˜ê³µë‹¨ì— 따르면 ë¹„ê¸‰ì—¬ì ˜ë£Œë¹„ëŠ” 2014ë…„ 11ì¡°2000ì –µì› ì— ì„œ 2022ë…„ 17ì¡°6000ì–µì› ìœ¼ë¡œ 급격히 치솟았다.

보험업계 ê´€ê³„ìž ëŠ” “ì‹¤ì† ë³´í—˜ì € 3900ë§Œëª…ì ´ 가입해 ‘ì œ2ì ˜ êµë ¯¼ë³´í—˜’ì ´ë ¼ 불린다”ë©° “êµë¯¼ë³´í—˜ê³¼ 함께 사회 ì•ˆì „ë§ ì—í• ì „ 해야 í•˜ëŠ”ë ° 비급여가 ê´€ë ¦¬ë ˜ì§€ ì•Šì•„ ì‹¤ì† ë³´í—˜ë¿ ë§Œ ì•„ë‹ˆë ¼ êµë¯¼ë³´í—˜ë „ ë§ ê°€ì§€ê³ ìžˆëŠ” ìƒ í™©ì ´ë‹¤. ì ´ë²ˆ ì ˜ë£Œê°œí˜ ì— ì„œ 비급여 ì§„ë£Œê¸ °ì¤€ê³¼ ê°€ê²©ê·œì œê°€ ìµœìš°ì„ ì 으로 ë…¼ì ˜ë ¼ì•¼ 한다”ê³ ë§ í–ˆë‹¤.

â—Žê³µê° ì–¸ë¡ ë‰´ì‹œìŠ¤ [email protected]

Considering the concerns‌ about potential social isolation and the loss of face-to-face interaction, how can‌ “untact” businesses in South Korea evolve to foster a sense ⁢of community and connection among users?

‌ This Korean text discusses the increasing number of “untact” (contactless) businesses in South Korea. It highlights the growth, challenges, and potential future of this trend. Here are some ⁣open-ended interview questions divided‍ into thematic sections:

**Section 1: Growth and Impact of Untact Businesses**

* This article shows a significant increase in “untact” businesses. What ⁤factors do ⁣you think are driving this trend in South Korea?

* How is the rise of ​”untact” businesses impacting ‌traditional brick-and-mortar businesses in Korea? Do you see this trend as a threat or an ​opportunity for them? ⁢

* ‍Beyond the numbers, how is the⁣ growth of⁣ “untact” businesses changing the daily lives and experiences ⁣of South Koreans?

**Section 2: Challenges ​and Opportunities for Untact Businesses**

* What are some of the⁤ key challenges that “untact” businesses face in South Korea, and how‌ are they overcoming ⁢them?

* What are the potential long-term economic and social ‍implications of the continued growth ​of “untact” businesses?

* Do you think the success of “untact” businesses in South Korea can be replicated in other countries? ​What are ​the factors that might make it‌ easier or harder to do so?

**Section 3: The Future of “Untact” in Korea**

* What​ innovations‍ or advancements do you‌ foresee in the “untact” sector⁣ in South Korea in the next five to‌ ten years?

* How do you ⁢think the government and policymakers should support ⁢the development‌ and growth of “untact” businesses?

* Do you believe “untact” ​businesses will eventually⁤ become the dominant mode of business in South Korea, or will there always be a place ⁢for traditional in-person interaction? Why or why not?

**Additional Tips for the Interview:**

* **Encourage diverse perspectives:** ⁣Invite interviewees from different backgrounds and with varying opinions on the ⁢topic.

* **Use follow-up questions:** ‍ Delve deeper into responses by asking for specific examples, personal experiences, or alternative ​viewpoints.

* **Be mindful of cultural context:** Consider how Korean cultural norms and ​values may influence perspectives on‌ “untact” business.

* **Promote critical thinking:** Encourage interviewees‌ to analyze the information presented in the article and formulate their own informed opinions.