The Ministry of Health and Welfare yesterday stated that it would improve health insurance system for low-income families. What attracts our attention is government’s decision that it will make those who go to medical institutions more than they should go to designated clinics, hospitals or pharmacies. The government’s medical supports for underprivileged people are basic principles of a welfare society. However, it is a different story that taxpayers’ money has been wasted unreasonably due to ethics insensibility by some medical beneficiaries and institutions who take advantage of medical aid system, and careless management by the government agencies. The result of investigation conducted by the government revealed that absurd situations in health insurance system were incomprehensibly serious. Thousands of prescriptions for mentally disabled people have been made out and filled for some immoral people who were not actually disabled at certain clinics and pharmacies. There even was a case that 54 prescriptions were made for one person at 27 clinics and hospitals in a day. Drug abuse was also a very common thing. It is reported that last year’s budget for medical costs was about 3 trillion won, up by 60% from three years before, but it was not enough to cover medical expenses some of which, therefore, had been paid for a while. If some people keep taking advantage of legal loopholes like this, the government’s attempt to increase budget will be useless. Currently, the number of people who have benefited from the medical care amounts to 17.6 million. It is certain that the medical costs will highly increase because the scope of the beneficiaries will be expanded into pregnant women, disabled people and senior citizens, and medical coverage will also be extended. That will cause more burden on people. It is said that the government has been working out measures to address those problems. We urge the government to introduce a new medical management system which can increase efficiency and transparency. Also the government should conduct close examinations into medical aid system and impose strict punishments on those who were involved in medical wrongdoings in order to establish moral and ethical principles. The National Assembly’s report showed that quite a few people were exempted from paying health insurance payment although they could afford. Therefore, the government should put every efforts to prevent waste taxpayers’ money and select people in real need through combining four national insurance programs.
줄줄 새는 의료비 지원, 종합대책 세워야
보건복지부가 어제 저소득층 등에 대한 의료급여 제도를 개선하겠다고 발표했다.
특히 의료기관을 과다 이용하면 지정된 병원. 약국만 다니도록 하겠다는 내용이 눈에 띈다.
정부가 사회적 약자에 대한 의료 지원을 하는 것은 복지사회의 기본이다.
그러나 ‘정부 돈은 봉’이라는 일부 의료급여 이용자. 의료기관의 도덕적 불감증과 정부의 관리 부실로 인해 국민 세금이 엉뚱하게 줄줄 새는 것은 전혀 다른 이야기다.
정부 조사 결과 비리 실태는 상상을 초월했다.
정신지체 환자를 이용해 수천 장의 처방전을 받아내 몇몇 특정 약국에서 조제하는가 하면, 한 사람이 하루 27개 병.의원에서 54개의 처방전을 받는 일도 벌어졌다. 오겞꼬?또한 비일비재했다.
지난해 의료급여 예산은 3년 전보다 60%나 많은 3조여원이었지만, 예산 부족으로 일부 진료비가 한동안 체불됐다고 한다.
이렇게 관리에 허점이 많다면 아무리 예산을 늘려도 밑 빠진 독에 물 붓기 식이 아니겠는가.
의료급여 대상자는 매년 늘어 176만 명에 이른다. 앞으로 의료급여 대상자가 임산부. 장애인. 노인으로 확대되고, 건강보험 보장 범위도 늘어날 예정이어서 의료 급여가 더욱 늘어날 것은 확실하다.
그만큼 국민 부담이 크게 늘어날 것은 뻔하다. 정부도 이에 대비해 대책을 마련하고 있다고 한다.
이번 기회에 효율성과 투명성을 높이는 종합관리 시스템 도입 등 철저한 대책을 세워야 한다.
부정행위를 한 의료기관에 대해서도 엄중하게 조사하고 처벌해 의료급여제도의 도덕성을 세워야 한다. 아울러 부실한 조사로, 납부 능력이 있으면서도 건강보험료를 탕감 받는 사례가 적지 않음이 국회 보고자료를 통해 드러났다.
이런 문제도 4대 보험의 통합 과정에서 분명히 걸러 돈이 불필요한 곳에서 새지 않도록 하는 노력이 필요하다.
<중앙일보 8월 23일 사설>
