'Disks are like a cold'... 2016 KBS exposé on excessive medical treatment for indemnity insurance

The KBS 'Current Affairs Window - Customer, You Have Indemnity Insurance, Right' episode, which exposed the reality of some hospitals and patients surrounding indemnity insurance, is available on the YouTube channel 'KBS Documentary'. This program, broadcast on March 22, 2016, also highlighted how excessive medical treatment affects the national health insurance, which serves as a safety net for public healthcare. The uploader stated that since the video was produced in 2016, the current situation may differ.

The broadcast begins with a suspicious conversation where a hospital employee and a patient exchange talk about pocket money. One person appearing in the broadcast explained that the structure is such that consumers bear all the stakes, while the insurance companies and hospitals take all the money, meaning consumers are essentially being treated as 'easy targets'.

What a 17-year veteran orthopedic specialist said about 'doctors' lies'

An orthopedic specialist with 17 years of experience working at a joint and spine hospital in Suwon stated that he agreed to the interview to prevent the trust between all doctors and patients from breaking due to the wrongdoings of a few, and to help patients easily find doctors who provide proper treatment. He explained that the most basic steps in treating a disk are medication and rest, followed by injection therapy, and then surgery. He also pointed out that if a doctor delivers accurate information to a patient, the patient always makes the right choice, but because hospitals that view money in an undesirable way provide false information, patients cannot distinguish them. This is what is called 'doctors' lies'.

At the hospital where he works, there was a continuous line of patients with various joint issues, especially waist issues, such as neck and lumbar disks. According to the broadcast, the number of patients with spinal diseases exceeds 12 million per year, and as society ages, degenerative diseases like joint and spinal diseases are bound to increase. When the reporting team gathered actual treatments used in frontline hospitals and categorized them by whether they are covered by national health insurance, approximately 80% were expensive treatments not covered by national health insurance. It was also pointed out that spinal diseases underwent 3 to 7 times more surgeries per capita than in Japan, with the biggest reason cited as the increased supply due to the proliferation of specialized hospitals.

Treatments embroiled in excessive medical controversies were also continuously increasing. The broadcast pointed out that radiofrequency ablation, which was heavily advertised in 2007, is reappearing along with indemnity insurance after adding new functions following increased dissatisfaction and criticism. One specialist said that even colleagues who are university hospital professors often do not know exactly what the current lumbar treatments mean.

After visiting about 10 hospitals, only about one provided proper care

The reporting team visited hospitals with an ordinary woman in her 50s, Im Ji-sun. As a result of the examination, no particular diseases were identified for Im other than obesity and hypertension. Over the course of a week, Im received treatment at about 10 hospitals in Seoul, Gyeonggi Province, and Incheon, and in almost every hospital, the same process of suggesting expensive tests first was repeated.

Im said that she visited about ten hospitals, but it felt like only about one of them provided proper care. That hospital diagnosed her by stating that there were no neurological paralysis symptoms, bowel movements were normal, and since a disk is a disease that improves on its own, they recommended physical therapy first. When the crew revealed their identity and asked for an opinion, this doctor explained that a disk is similar to a cold. He said that they would perform surgery in cases of very specific complications, but it is like treating most colds based on symptoms. On the other hand, Im reported that the remaining hospitals all spoke as if she were in pain even though she wasn't, making it hard to trust them.

According to Im, one hospital first brought up the topic of surgery and then mentioned procedures, and when she said she could not undergo surgery immediately, they advised her to at least get an injection first. Im said that this injection, which took less than 5 minutes, cost 300,000 won, but it did not seem to have much effect on her. There were also hospitals that guided her toward rehabilitation treatment in packages of multiple sessions.

With indemnity insurance, expensive treatments are not an issue

The broadcast pointed to indemnity insurance as the reason why excessive medical treatment does not decrease. It stated that because indemnity insurance is available, people do not question expensive treatments, and it is extremely rare for people to complain even if they receive expensive treatments and they are ineffective. One specialist said that whether a treatment that does not need to be recommended was recommended is inevitably a medical judgment that doctors must evaluate, and the most important thing is the doctor's own conscience. The explanation is that there may be cases in some medical institutions where they do so for secondary gains even though it is not absolutely necessary. Another specialist expressed regret, saying that those who suffer from the excessive treatment of some doctors are often people who trust medical professionals well, such as the elderly or those living in rural areas.