'Essential' medical treatments became more profitable but continue to decline: data

Despite improvements in financial compensation for life-saving medical treatments, government data shows a continued decline in the proportion of such treatments being performed in a year.

According to Health Insurance Review and Assessment Service data, revealed Thursday by Rep. Kim Mi-ae of the main opposition People Power Party, the percentage of the so-called essential medical treatments accounted for 19.2 percent of all medical costs in 2024. This marks a continued downward trend from 20.9 percent in 2022 and 19.3 percent in 2023.

In South Korea, an "essential medical treatment" refers to care that, if delayed, greatly affects a patient's life and health. These treatments are expected to be provided equally regardless of region and time, and given priority in the public health care system, according to the 2021 definition by the Korean Medical Association Organization. It is a socially accepted term for which a legal definition does not yet exist.

Medical treatments related to emergency, trauma, heart, brain, cancer and intensive care, as well as severe infectious diseases, are all fields conventionally accepted as essential.

Rep. Kim's report showed that the relative value scale for thoracic and cardiovascular surgeries, neurosurgery and pediatric surgery all increased, according to the assessment by state health insurance authorities that determines medical staff's reimbursement rates. This means doctors are getting paid more, from both the patients and the government-funded insurance system, for performing these critical surgeries that they did before.

Despite this, the total amount received for such essential surgeries decreased, the report showed, suggesting that fewer life-saving surgeries were performed compared to before. In turn, this indicates a shortage of medical staff available to carry out surgeries in critical fields.

The National Health Insurance Service revealed in October 2024 that the proportion of stomach, colon and liver cancer patients receiving surgery one month or more after diagnosis has been steadily increasing. Between 2015 and April 2024, the rate moved from 30.9 percent in 2015 to as high as 40 percent in 2022.

Chronic staff shortages, coupled with the mass walkout last year, resulted in fewer cancer surgeries than before. April data from the NHIS showed that 25,680 people received surgeries for the seven most common cancers in the country between Feb. 20 and Oct. 31 last year. This was down 7.3 percent compared to the same period the previous year.

"The government belatedly hiked the relative value scale, but the essential medical fields still face low medical fees and shortages in personnel ... A comprehensive measure such as incentives for (less popular) regions, measures to fill the staff shortage in emergency medicine and pediatrics, and other measures are necessary," Rep. Kim said.