대형종합병원의 선택진료비 및 치료재료비의 부당징수 행위에 대한 연구 (The Study on large general hospitals’ unfair charging fees for selecting a doctor or for medical materials by using their superior position to the patients. - Centered on the recent Korean FTC’s Decis)

서지정보

· 발행기관 : 한국경쟁법학회
· 수록지 정보 : 경쟁법연구 / 22권 / 264 ~ 285페이지
· 저자명 : 서석희

초록

국민건강보험법의 규제영역은 당해 규제영역을 창설한 근거법률인 국민건강보험법과 그 관계법령에 의하여 완결적으로 규제되고 있는 영역으로, 건강보험제도의 목적 달성을 위하여 반드시 요구되는 입법사항이 흠결되어 있어 다른 법률에 의한 보충적인 규제가 필요하다는 등의 특별한 사정이 없는 한, 국민건강보험법의 규제 사항에 관하여 공정거래법을 비롯한 다른 법률이 개입은 신중해야 한다고 본다. 문제는 공공재(public goods)적 성격을 갖는 보건의료서비스에 대해 어느 정도의 시장논리 개입이 가능한가에 있다 하겠다. 이건과 관련하여 피심인의 선택진료가 기본적으로 환자와 의사간 정보의 비대칭성에서 비롯된 점 및 치료재료비 징수 행위는 환자에 대한 최선의 진료를 위하여 실제로 진료에 사용된 치료재료 등에 대한 실비 보상의 성격을 갖는 점 등을 고려할 때 피심인의 이러한 행위가 국민건강보험법령에 위반될 수 있음은 별론으로 하고, 이러한 거래가 환자에 대하여 불공정한 내용을 가지고 있다거나, 위 거래에 의하여 거래 상대방인 환자가 어떠한 불이익을 입은 것으로 볼 수는 없다 할 것이므로, 피심인의 행위 중 일부가 제도상이나 구조적으로 개선할 점이 있다고 하더라도, 이를 공정거래법상의 거래상 지위남용행위 중 불이익제공에 해당한다고 평가하는 것에 쉽게 찬성하기 어렵다 할 것이다.

영어초록

On 28th September 2009, the KFTC imposed the surcharge of 3.04 billion won with the order of correction on 8 large general hospitals for levying unfair expense of selecting doctors or medical materials by using their superior position to the patients.
The target hospitals of the order of correction include the Korean prominent general hospitals, such as Seoul Asan Hospital, Sin-chon Severance Hospital, and Sam-sung Seoul hospital, and the order was the result from the investigation that had been preceded from July to September 2008.
There were several types of acts that violated the Monopoly Regulation and Fair Trade Act such as unfair charging fees for selecting a doctor(8 hospitals) or materials for medical(2 hospitals). KFTC judged that this violation were under the “Offering Disadvantage” which is one of the type of “Unfair trade practices” under the Article 23.1.4 of the Monopoly Regulation and Fair Trade Act (Unfairly Taking Advantage of One’s Position in Trade).
In the large general hospitals, doctors had more access to information than patients, and patients had limitations in selecting their hospitals and doctors. In this situation, the hospitals unfairly took the advantage of their position to patients in trade. As a result, the trade between the hospitals and patients became abnormal therefore patients couldn’t expect the unfair charging fees and should have paid fees unfairly. In this respect, the KFTC judged that the hospitals violated the law.
The KFTC imposed the surcharge of 3.04 billion won with the order of correction on 8 large general hospitals for levying unfair expense of selecting doctors, and gave the order of correction on 2 hospitals for levying unfair charge of medical materials. This judgment was meaningful, because it was the first time applying Fair Trade laws to Korean prominent general hospitals’ process of charging fees.
However selecting doctors were caused by the dissymmetry of information between doctors and patients. Charging fees on medical treatments also were the kind of ‘actual cost compensation’ for the patients. According to these facts, even though the structural and systematic improvement of the hospitals was necessary, the judgment, that these actions were under the “Offering Disadvantage” which was one of the type of “Unfair trade practices” under the Article 23.1.4 of the Monopoly Regulation and Fair Trade Act (Unfairly Taking Advantage of One’s Position in Trade), should be carefully examined.

참고자료

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