In the past and now, the public is talking about medical reform from a life perspective. Professor Lee has now provided some organization, and I have tried to organize it from a consumer perspective. The public wants medical services that are more patient-centered than now, they need medical services that are more efficient than now, and they need medical services with reduced medical disparities than now. Lastly, I hope for a medical system where essential medical specialists can work without difficulty by providing an environment where they can work. I have summarized these nine points a bit. Therefore, consumers should not only think about consumers but also supply enough rewards and satisfaction for providers in the medical environment.

Consumers have a very high awareness that such benefits can also come back to them. When we look at the content of our contest, we can feel that. Therefore, in any case, the medical services that the people want, so in any case, the medical market has been very supply-oriented so far. To address various issues that arise, ultimately, I think we need to reconsider shifting towards patient-centered and consumer-centered approaches. Professor Hong Yoon-chul mentioned a lot about value-based healthcare in the materials earlier. Until now, our medical market has been based on fee-for-service, which has various problems even if the fees are low. However, regardless of that, medical services are centered around the quantity of services.

If we say that those parts have been realized, then in terms of the aspects that change the career path based on value, there needs to be some qualitative changes. I think that these aspects related to urbanization are something that medical consumers, from the perspective of medical consumers, would all agree on. Therefore, through this, it is thought that we can utilize limited medical resources more efficiently and increase the efficiency of health insurance. So, I think that in terms of consumer orientation, some innovation is needed in the direction of medical reform in the provision system of medical services and also in the innovation of payment and reimbursement systems for medical services. Therefore, within that, from a consumer perspective, it seems necessary to strengthen primary care a bit more, and it seems necessary to reform the regional comprehensive medical delivery system where you can receive medical services without discrimination regardless of where you live.

Some aspects need to be thoroughly managed in terms of distorting the medical market a bit, leading to social costs being somewhat high-cost and non-insured, and ultimately, it seems necessary for the guarantee rate of health insurance to increase a bit in order to reduce these things. I think that the management of actual expenses insurance and non-insured needs to be done more thoroughly. In the end, in order for these things to decrease, I believe that the guarantee rate of health insurance needs to increase a bit. And I mentioned that the healthcare market now needs to shift from being supplier-centered to a bit more consumer-centered. However, in order to do that, it is crucial to create governance where consumers can participate in policy changes or reforms in some way, in any form, or in any content. So, I think it is very important for parts where consumers can participate in governance to be established. Therefore, in the medical field, although the medical association claims that medical issues should be dealt with by medical professionals, I believe that the era has changed in some way, and there has been a shift in paradigms. I think that in terms of medical policies, it is important to consider consumers' opinions.

Through this kind of governance, there are many more areas that can be resolved, and by doing so, I would like to say that I can improve something much more efficiently and quickly. However, when we look at the current situation of primary care in Korea, there are structural limitations and problems. Therefore, there is a problem where the function and role of primary care are somewhat blurred with specialized medical care. Additionally, there are fragmented aspects in the services of primary care, such as quick consultations or three-minute consultations. Consumers seem to lack trust in these medical services, and there are issues such as duplicate examinations, overdiagnosis, and underdiagnosis.

Consumers tend to perceive that there is a lack of the number of doctors responsible for medical care and a lack of expertise within that. As repeatedly mentioned, issues arise in the medical market distorted through solid insurance. Furthermore, problems arise from the trend of consumers engaging in medical shopping, focusing on tertiary hospitals. Nevertheless, various issues stemming from structural problems in primary healthcare lead consumers to have somewhat limited trust in primary healthcare. Therefore, in order to strengthen consumer trust in primary healthcare, it is believed that the aspects related to the values-based medical care we aim to provide can naturally be connected to these issues. In order to do so, we need to talk more about the aspects of values-based medical care.

It seems necessary to have qualitative medical care that is not based on the quantity of the team. Therefore, it seems essential for various aspects such as counseling, treatment, and integrated preventive medicine to be comprehensively implemented. It also seems necessary for aspects related to the introduction of a patient-oriented care system. Professor Lee mentioned voluntary participation of patients in hospitals. I also think that making this mandatory is not desirable initially. Therefore, it would be good to have a system where patients can voluntarily register and, if not satisfied, can naturally move to another facility. It would be beneficial to establish a medical delivery system, as well as to have organic coordination between primary care clinics and tertiary hospitals with specialized doctors. It is necessary to have a system and environment where tasks and sharing can be freely carried out.

It seems necessary, and then there should be integrated management that is somewhat linked to care, such as emergency medical care, preventive health, chronic disease management, and mental counseling. Anyway, within that, it seems like consumer trust would increase. Securing aspects such as consumer convenience, like visiting or remote medical care, would enhance the trust of consumers in primary care. I think that there is a need for parts that can strengthen consumer trust through such measures. I think that some improvements in these areas need to be made quickly. Regarding the establishment of a local medical delivery system, this part is now necessary. Ultimately, the establishment of a medical delivery system restricts some aspects of consumers freely choosing and using medical institutions as they do now, so I think it needs to cover the disadvantages that come from these restrictions in terms of convenience.

I think the advantages need to be emphasized a bit, so in that aspect, improvements in the performance-related aspects through value-based healthcare need to be made. I believe it is crucial for consumers to recognize and understand those aspects. Therefore, in order for consumers to recognize and understand these things, I believe that support systems that can help consumers make choices should be in place and should function organically. Selecting the necessary medical services and ensuring that consumers can understand them is crucial, in my opinion. Therefore, I think it is essential to create an environment where understandable information can be provided, and then, based on scientific evidence, producing and disseminating objective information is important. When consumers use and choose these medical institutions and if there is any dissatisfaction, it is important to address it.

Systems that can quickly consult and handle these aspects are essential in transforming and assisting consumers in making the right choices. I believe that these systems, whether provided by the government or other consumer organizations, play a crucial role. In addition to the government, these systems in the healthcare sector need to enhance information provision on a more public level. Therefore, improvements in the consumer-centered national health insurance system, especially in managing total medical expenses, are vital from the consumer's perspective. I also think it is important to consider non-insured medical expenses and the linkage between private insurance and national health insurance.

Some parts need to be additionally reviewed. Finally, in order to sustain health insurance, what role should consumers play? I have pondered a bit on this. First of all, as I mentioned before, consumers' awareness of the public nature of healthcare has greatly increased amidst the chaos of COVID-19 and medical supply shortages. Nevertheless, healthcare involves the utilization and distribution of very limited resources, so I believe it is crucial for consumers to recognize the public nature of healthcare. Therefore, I think it is essential for consumers to be willing to give up certain aspects in healthcare, even if they experience some inconvenience, so that others, especially severe patients, can receive help. I believe that such sacrifices have become more feasible now.

I would like to mention that consumer organizations will make efforts to help consumers recognize the public nature of healthcare more so that such things can spread further. Secondly, there seems to be a need for some improvement in the culture of healthcare utilization. Therefore, in terms of systems and of course, regulations, it would be great if experts could contribute a lot. From the perspective of consumers, regarding the culture of healthcare utilization, the reality is that consumers in Korea tend to use medical services excessively. Ultimately, to reduce such limited resources, it is essential to refrain from unnecessary healthcare utilization. Therefore, I believe that encouraging consumer behaviors to reduce excessive healthcare utilization should be a key point.

In order to do this, ultimately, advanced general hospitals need to create an environment where patients with severe rare diseases can access. To do this, it is a bit challenging for consumers to distinguish between mild and severe cases. When I think about it from my perspective, everyone thinks they are severe, but it is important to change such perceptions a bit. Therefore, it seems necessary to improve the culture of medical care in advanced general hospitals, including the emergency room, so that patients with severe rare diseases can receive concentrated treatment. Next, in terms of primary care, it seems that creating a trustworthy environment for consumers is necessary, and based on that premise, consumers should be able to manage their health well through the use of primary care.

So, by doing that, I think that the parts that can be resolved before going to a tertiary hospital are the parts related to medical use, through improving the culture of medical use. Therefore, I think that I can address those parts. So, we will continue to study a lot in the future, but through those efforts, we will educate and persuade consumers and, in any case, make efforts to create an environment where those parts can be improved through campaigns.

소비자 관점에서 국민이 원하는 의료 서비스란 무엇이며, 소비자로서의 의무는?

소비자 관점에서 국민이 원하는 의료 서비스란 무엇이며, 소비자로서의 의무는?