If
hospital bills are too high compared to income, a family’s life can be ruined. These excessive hospital expenses are called catastrophic medical expenses, and statistics show that 4.6% of households in Korea are suffering from these catastrophic medical expenses. Today (11th), a series of projects examining the reality and alternatives to catastrophic medical expenses, we will first look at the story of Happiness, who was born 17 months ago.
This is medical reporter Jo Dong-chan.
<Reporter>
It was awkward to see Happy wipe his left arm with an alcohol swab and then pick up the syringe.
[I’m Sorry Mom]
Happy Mom, a non-medical person, is learning how to give injections from her nurse.
Happy, who is 17 months old, has suffered from a high fever of unknown cause since birth.
[Happy Mother: The child wakes up in the morning and cannot wake up. She just sits and cries.]
After undergoing tests at numerous hospitals, she was diagnosed with ‘hereditary relapse syndrome.’
It is a rare disease in which fever occurs repeatedly because inflammation does not subside due to a genetic abnormality.
[Kim Seong-heon/Professor, Department of Pediatrics, Seoul National University Hospital: It is a very serious disease that requires lifelong medication. Without treatment, the children’s prognosis is not so good and they will not be able to enjoy their normal life expectancy.]
Fortunately, after hospitalization, they are able to walk as well as other children their age, and are now about to be discharged.
However, what happens after discharge is more problematic.
This is because you have to get injections at home every day.
[Happiness’s mother: My child is in so much pain even after only a few days of injections. I feel at a loss right now because I think I have to inject this into my child every day.] [Kim Seong-heon/Professor of Pediatrics and Adolescents at Seoul National University Hospital: The pain is a bit severe
. The injections also have to be stored in the refrigerator and protected from light, so they cannot travel anywhere.]
The injection and hospital expenses, which exceed 600,000 won per month, are also burdensome.
This is because it exceeds 20% of monthly income.
The government supports disaster medical expenses for recipients of basic livelihood security and the next-lowest class when out-of-pocket medical expenses exceed 800,000 won, and for low-income families even when medical expenses exceed 10% of annual income.
However, a survey by the National Health Insurance Corporation found that quite a few households collapsed due to the burden of hospital costs even if their rates were lower than the standard.
(Video coverage: Se-kyung Kim, Video editing: Sang-min Lee, CG : Seong-yong Hong, Jegal – chan)
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<Anchor>
Q. What is the best way to support disaster hospital expenses?
[Cho Dong-chan/Medical Reporter (Specialist)바카라: Medical situations need to be examined individually, so let’s see what other countries are doing. Happy is also getting injections every day now. However, the standard injection treatment for hereditary relapsing fever syndrome is administered once every two months. This injection was introduced to Korea in 2015, but it is still not covered by insurance, so the entire annual drug cost of 157 million won is borne by patients. However, Switzerland and the United Kingdom have applied insurance since 2009, and Japan has applied insurance since 2011, and insurance is currently applied in 36 countries. In Korea, internationally recognized injections are covered at your own expense, and other alternative injections that need to be administered every day are covered by insurance. ]
Q. Is Korea’s ‘cost-effectiveness’ a priority?
[Cho Dong-chan/Medical Reporter (Specialist): This is because our country prioritizes cost-effectiveness. The injections that Happy takes every day cost 83 million won per year. However, the cost of injections given once every two months is 157 million won. National support, such as special provisions for rare disease calculations, is applied only to daily injections, which are inexpensive, so patients only have to pay about 6 million won. It is very unusual for another treatment to receive government support instead of a treatment recognized by the international community. ]
Q. Should we value practical help for patients?
[Cho Dong-chan/Medical Reporter (Specialist): Considering health insurance finances, it would be better to use the cheaper drug if it has the same effect. However, as in the case of Happiness, there are many cases where insurance coverage needs to be reexamined to ensure that it actually helps patients. The government said it would strengthen coverage for rare diseases, but it will be difficult to achieve the policy goal if only cost-effectiveness is uniformly considered as it is now. Insurance coverage of this injection will be discussed again on September 15th.]