@article{ART003351151},
author={Sang-Hyun Ahn and Cheong Yooseok},
title={How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions},
journal={Korean Journal of Medical Ethics },
issn={2005-8284},
year={2026},
volume={29},
number={2},
pages={119-130}
TY - JOUR
AU - Sang-Hyun Ahn
AU - Cheong Yooseok
TI - How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions
JO - Korean Journal of Medical Ethics
PY - 2026
VL - 29
IS - 2
PB - The Korean Society For Medical Ethics
SP - 119
EP - 130
SN - 2005-8284
AB - This study examines the structural mechanisms through which South Korea’s private indemnity health insurance, covering approximately 70% of the population, drives overtreatment. Building on the “overtreatment trilogy” (2015–2016), we prioritize private indemnity insurance as a primary analytical focus. Through a thematic synthesis of Board of Audit and Inspection (BAI) data comprising roughly 1 billion claims records (2018–2022) and public health statistics, we identified six structural mechanisms: non-covered service market expansion, physician and patient moral hazard, tacit doctor-patient collusion, National Health Insurance (NHI) fiscal erosion, diminished medical professionalism, and supplier-induced demand. BAI data indicate that private insurance subscribers generate at least 12.9 trillion won in additional annual medical costs, with 3.8–10.9 trillion won shifted to the NHI. Despite four generations of product reform (2009–2024), a persistent “balloon effect” redirects overuse to newly emerging non-covered services. Applying the framework of Reinhold Niebuhr’s Moral Man and Immoral Society, we argue that the solution lies not in training moral physicians but in designing moral systems where ethical practice becomes the default.
KW - private indemnity insurance;medical overuse;professionalism;moral hazard; motivation;ethics;medical
DO -
UR -
ER -
Sang-Hyun Ahn and Cheong Yooseok. (2026). How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions. Korean Journal of Medical Ethics , 29(2), 119-130.
Sang-Hyun Ahn and Cheong Yooseok. 2026, "How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions", Korean Journal of Medical Ethics , vol.29, no.2 pp.119-130.
Sang-Hyun Ahn, Cheong Yooseok "How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions" Korean Journal of Medical Ethics 29.2 pp.119-130 (2026) : 119.
Sang-Hyun Ahn, Cheong Yooseok. How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions. 2026; 29(2), 119-130.
Sang-Hyun Ahn and Cheong Yooseok. "How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions" Korean Journal of Medical Ethics 29, no.2 (2026) : 119-130.
Sang-Hyun Ahn; Cheong Yooseok. How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions. Korean Journal of Medical Ethics , 29(2), 119-130.
Sang-Hyun Ahn; Cheong Yooseok. How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions. Korean Journal of Medical Ethics . 2026; 29(2) 119-130.
Sang-Hyun Ahn, Cheong Yooseok. How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions. 2026; 29(2), 119-130.
Sang-Hyun Ahn and Cheong Yooseok. "How Does Private Indemnity Insurance Distort Physicians’ Practice Patterns? Overtreatment-Inducing Mechanisms and Structural Solutions" Korean Journal of Medical Ethics 29, no.2 (2026) : 119-130.
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