A $100,000 American Medical Bill

The retirement ceremony of Assistant Secretary of State John Negroponte, who devoted 40 years of public service to the State Department, took place last February. Negroponte, a man of large stature, fell on the stage while receiving and passing a memento given to him by the State Department, perhaps due to tangled feet. Fortunately Negroponte got up right away and joked, “At least I still have health insurance.” While the audience laughed, most Americans including those in that audience are in no position to laugh his statement off as a joke. That is because America is a country where being sick can make a person drop to hell in one night.

American medical costs are “murderous.” A little child who appeared on TV after last year’s American presidential election said, “President Obama, my grandpa died because he did not have money to pay for treatment. Please make sure there are no people like my grandpa.” Like this grandfather, people who die without receiving sufficient treatment because of money are estimated to number several tens of thousands per year. Households that declare bankruptcy due to medical costs in the U.S. now number 80,000 households per year. The saying that medical costs are “murderous” is not at all wrong.

If medical costs are “murderous,” then health insurance costs are “shocking.” In the U.S., a decent health insurance plan costs over $1,000 per month. That is no ordinary burden. Indeed, over 50 million Americans lie in a medical blind spot—one-sixth of the entire population. This terrifying number is increasing rapidly. Every month, 500,000 newly laid-off workers and their families immediately fall into the medical blind spot.

America is a country where you cannot even complete a medical checkup at a hospital in one day. Many Koreans living in America with somewhat more economic means go to Korea to receive medical checkups.

President Obama, as other previous presidents, has set health insurance reforms as a top priority and is wrestling with it, but the outlook is bleak. The very fundamentals of the American system are flawed. American health insurance is like a giant system in which innumerable medical industry agents under sloppy regulations prey on patients and patients’ families for all sorts of excuses.

A Korean staying in Washington D.C. almost got preyed on by this system. He needed two surgeries due to intestinal problems. The sum of all the medical bills sent to him after the first surgery in the U.S. was “75,000 dollars.” By contemporary exchange rates, that was over 100 million won. The bills were sent by around 10 different places, of which the most stupendous case is the following. The man was lying in a hospital bed after the surgery, when one woman came and said, “Stand up and walk.” That woman, who was from some medical organization, billed him 300 dollars after wards. The word “preying” is not at all inappropriate. Fortunately, this Korean person was able to escape from this man-eating system by paying 25,000 dollars (35 million won) due to the traveler’s insurance he acquired when coming to the U.S.

He got on the plane to Korea without looking back and received the second surgery, which is more important than the first surgery, in Korea. Although the surgery and hospitalization time was almost the same as the U.S., the entire medical costs were 1.2 million won [~1,000 dollars]. Everyone who heard this story could not but repeat “Our country, is a good country.”

Our health insurance also has many problems. The proportion paid by the patient is said to be 10 percent higher than in Europe. Nonetheless, the fact that in only 30 years we were able to have a health insurance system with this degree of medical quality, speed, and coverage is a “a miracle of social growth within the Republic of Korea” akin to our economic growth miracle.

While this is a result of all the citizens working hard, the role of the past presidents who proposed and built the basic framework of the country must be acknowledged. President Park Chung-hee is like the father of health insurance. He set the foundation for health insurance early on in his administration (albeit largely declaratory), and initiated health insurance as a full-fledged system in 1977.

Passing through the periods of President Chun Doo-hwan, Roh Tae-woo, and Kim Young-sam, our health insurance expanded to agricultural/fishery regions and the self-employed, attaining medical coverage for all citizens. President Kim Dae-Jung united health insurance that had been divided between occupations and regions, and President Roh Moo-hyun greatly increased support for cancer treatment. Also, last year we started support for the elderly requiring long-term care, thereby greatly reducing household burdens. All these are steps are difficult to take without the conviction of the presidents. Now our medical field can compete in the world market even as an industry.

I wonder what the residents of North Korea will one day feel as the greatest blessing when the Korean Peninsula is unified. I think that it will be our health insurance. I believe that health insurance is like a fortress that protects a liberal democratic regime. Although our presidents committed many mistakes and recently the hypocrisy of one of them is angering the people, the reason they are still deserving of thanks is that they cannot be discounted among those who have built and protected this strong fortress.