[Korea gimmingyeong financial newspaper reporter] next month indemnity health insurance system is changed with the launch of new products. The product structure reorganization gotta split into basic type, riders and two years immediately preceding uninsured medical expenses unclaimed egen gives customers a premium discount. As the premium hikes here five years but also reduced insurance loss ratio is also expected to grow keulji cuts jeongjak how consumers feel it is unknown.
◇ 新 released next month indemnity insurance ... Financial authorities premiums downward pressure
The recent financial authorities and the insurance industry is reportedly ahead of the indemnity insurance market to launch next month to discuss the final premium rates.
The financial authorities have rates in line lowered approximately premiums previous year by 25% approximately, manual therapy, extracorporeal shock wave and proliferation care, uninsured injections, uninsured may join both the three riders separated by MRI and 7% when you buy only the basic pushing to be determined. To this end, the financial authorities are being asked recommends applying a lower rate over last year's average of 20% in the insurance industry than it is now.
The insurance industry is a position that is difficult. Indemnity insurance in recent years in terms haewatdaneun launch a premium hikes inevitable loss ratio rising to these cuts is reportedly claiming that excessive.
In addition, according to insurance supervisory regulations enforcement regulations new insurance products can not adjust the premiums until the contract statistics have accumulated five years. After all, the first rate determined at this time is that Shem next five years 新 indemnity insurance prices.
◇ consumers pay premiums increased Inha dwaetjiman
Doedo thus lowering the premiums determined jeongjak consumer experience is less expected.
新 indemnity insurance products because the self-pay ratio of riders and riders, instead of being separated into basic type is to rise to 30% from the current 20%. If the consumer received an allotment for example, one hour of manual therapy ₩ 100,000 will increase from ₩ 20,000 to ₩ 30,000.
Guaranteed amount and the number of riders is also set to prevent excessive 'medical shopping'. Manual therapy △ ₩ 3,500,000 sets annual cumulative annual guarantee limit, △ ₩ 2,500,000 uninsured injections, △ uninsured MRI is limited to 300 million. Even if the frequency of treatment injections guaranteed to set the number of uninsured could receive support each year through the 50th. If there is a limited number of MRI.
Industry insiders, because the existing indemnity insurance excess treatment and excessive spending structure there was in it did not improve the problem did not improve at all the axis of the core, said "it is necessary reform of the healthcare industry as well as financial 'he said.
◇ indemnity insurance reform, "half a solution"
Indemnity health insurance loss ratio of insurance companies led the increase is actually due Hospital uninsured care "from a large proportion. According to data from the Insurance Institute uninsured medical expenses that are not actually applying the number of health insurance accounts for two-thirds of the insurance payments and its share continues to increase, which also reportedly at 67.2% in 2012 to 68.6% in 2014.
In addition, the same survey showed that organizations bottles and 100 bottles high uninsured rate, according to lawmakers, Rep payment performance concentrated in the Seoul area, hospital grade, spinal joint hospital this year. Attitudes vary from hospital clinics are uninsured for the same grade disease was prominent. When a herniated disc cases (other intervertebral disc disorder) accounted for approximately 87% of the uninsured percentage of indemnity insurance payments statistics yieoteuna total copay of Greater General Hospital ₩ 3,580,000 hospital grade was found to be the differences more than doubled to 8.46 million won.
In particular, uninsured medical expenses of senior hospital had occupied the room balance and selection fee is about 70% to about 3.05 million won, hospital grade is shown to account for uninsured procedures and material costs are more than 80 percent to about 8.42 million won uninsured medical portion of the indemnity subscriber large It turned out to be. In the consumer high "small hospital" access to a conclusion that "pain relief therapy (manual therapy), mainly carried out most of the uninsured health care such as spinal joints it is obtained.
However, the Ministry of Health and Welfare as medical indemnity insurance industry has consistently called problem of product structure.
Industry insiders of medical health insurance rate 'OECD countries falls short of ages than in developed countries about 9-15% by 6.1%. While the insurance penetration rate, meaning the private insurance spending is arguing the first, second among OECD countries, he said.
Following "The reason for the increase of the insurance loss ratio is the result of designing a product fault. Should the regulation of private insurance sold 'he claimed, and' the time is inconvenient to focus only on the uninsured "moral hazard" no choice but to expand without worrying about the environment, "it showed an attitude.
Financial authorities do not address the fundamental issue of indemnity insurance issues, only sets out the reasons why the insurance industry is coming out of prison jwaegi criticism.
Financial Consumer Federation of contrast is' far indemnity insurance monitoring strengthened and it is non-cooperation of the Ministry of the healthcare industry cause there was no appropriate restrictions on spending structure, saying "the government in welfare reform dimensional innovative spending structure due to excessive care improvement should be presented with a comprehensive plan for the normalization of indemnity insurance 'naenwatda the claims.
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