Ministry, hospitals clash over fees for cancer surgeries

General hospitals and the government are at odds over discounted fees for a state-of-the-art method of gastric cancer surgery, with hospitals cancelling scheduled procedures because of reduced revenues.

Concerns are mounting over whether cancer patients will be able to get the surgery that involves a minimum incision, bleeding, pain and complications.

According to medical insiders and news reports, large hospitals in Seoul including Asan Medical Center, Korea University Hospital and Samsung Medical Center earlier this month canceled scheduled endoscopic submucosal dissections, surgery used for treating early stage stomach cancer. Other general hospitals in Seoul and rural areas have also reportedly notified their patients of cancellations

The medical facilities had reportedly performed around such 25 surgeries every week. The method is applied not only to gastric cancers, but also to polyps and early-stage cancers of the colon and esophagus.

About 26,000 people here reportedly develop gastric cancer every year and up to 15,000 ESDs are conducted annually.

The reason for the cancellations is that the procedure is covered by the national health insurance fund, meaning less profit for the hospital. Hospitals used to set the price at between 1.5 million ($1,300) and 3 million won per procedure. But under a new system, they will only be able to make around 300,000-500,000 won.

In addition, the ministry has approved ESD only for stomach tumors smaller than 2 centimeters.

The Korean Society of Gastrointestinal Endoscopy told local daily Chosun Ilbo that the numbers do not add up if the price is dropped to the government guideline.

“The knife itself costs 200,000-400,000 won,” it said.

But the Ministry of Health and Welfare said the price was decided upon in consultation with the Korean Medical Association. The authorities on Tuesday released a statement that the figures were based on reports by the KSGE, KMA as well as surgical knife makers including Olympus.

“Olympus needs to reveal its manufacturing cost first to revise the coverage fee,” a ministry official said.

The government advised esophagus or colon cancer patients to seek laparoscopic surgeries.

“Currently, ventrotomy or laparoscopic surgeries are effective, given the five-year-survival rate, complications’ rate and others. On the other hand, we still need to examine whether ESD is really effective in illnesses besides gastric cancer,” the ministry said.

By Bae Ji-sook  (baejisook@heraldcorp.com)