Should doctors charge more for telemedicine services?

While the government is pushing to launch trial telemedicine services connecting doctors with patients through the use of information and telecommunications technology, attention is growing on how medical fees for related services will be decided.

The medical fees refer to the sum of the costs covered by patients and the National Health Insurance Service (NHIS).

Korea has adopted medical services on a fee-for-service basis since the country introduced the medical insurance system.

Opinions have been divided over whether doctors should receive more medical fees for offering telemedicine services.

Supporters of higher fees say the services require more effort and work on behalf of doctors and other medical workers. But opponents say the services do not require spaces for consultation, so fees should be lower compared to general practice.

Non-face-to-face medical services, known as telemedicine, were allowed temporarily in Korea starting in February 2020 when the government raised the classification of COVID-19 to the top level of its four-tier system to cope with infectious diseases.

But the legal basis for such services would vanish when the government downgrades the classification of COVID-19 in time for the decision made by the World Health Organization (WHO) on Friday to declare an end to what it calls a public health emergency of international concern (PHEIC) regarding the coronavirus.

The government is pushing for the telemedicine pilot program as there has been considerable demand to continue non-face-to-face medical services even after the country's COVID-19 public health emergency ends.

The idea of the pilot program came as it would take a lot of time for the National Assembly to pass relevant bills to institutionalize the services due to conflicts of opinion between various parties involved.

The range of the medical fees and whether to increase them is decided by a committee within the Ministry of Health and Welfare after considering the types of services and inflation, among other factors.

Then, the NHIS and suppliers' organizations ― such as the Korea Medical Association and the Korean Dental Association ― decide on the rate of fee increase through negotiations.

A high medical fee leads to an increase in health insurance premiums as well as the financial burden on the NHIS.

Currently, patients pay the same cost if they actually go to a hospital to see a doctor or speak to a doctor on the phone. Doctors get a 30 percent bonus from the NHIS for consulting with patients through the phone.

The health ministry has maintained a position that it has yet to make a decision on the direction of the medical fee policy regarding telemedicine.

gettyimagesbankStill, Minister of Health and Welfare Cho Kyoo-hong recently signaled the possibility of applying higher medical fees for telemedicine compared to general practice.

"It is true that medical staff should give more efforts to offer telemedicine services," the minister said during a National Assembly session on April 24. "We need to consider costs as well as people's access to medical services. We will work to adjust the fee at a reasonable level."

In another Assembly session on March 21, Second Vice Minister of Health and Welfare Park Min-soo indicated his support for increasing the cost covered by patients for telemedicine.

"Non-face-to-face medical services give some benefits to patients as they can save time or transportation expenses," he said. "I think it would be right to adjust the cost covered by patients."

On the other hand, some lawmakers belonging to the Assembly's Health and Welfare Committee, including Rep. Jun Hye-sook of the main opposition Democratic Party of Korea, claimed the medical fees for telemedicine should be lower than those for general practice.

Rep. Jun cited overseas cases, saying, "Some foreign counties lowered the medical fees for telemedicine for regular patients. Nobody would agree if the government decides to increase the fees."

Data Rep. Jun received from the health ministry showed that some major countries set medical fees for general practice and telemedicine at a similar level. These countries include France, the United Kingdom and some states of the United States.

In Japan, medical fees for general practice and telemedicine are the same for regular patients.