It has been revealed that some national university hospitals are applying “international rates”—designed for medical tourists—even to undocumented immigrants, who are considered medically vulnerable. Medical costs for foreign patients at national university hospitals were, on average, 1.6 times higher than those for patients covered by the Medical Support Program for Vulnerable Foreigners, and 17.5 times higher for acute appendicitis.
On October 6, Rep. Kim Yoon of the Democratic Party of Korea, a member of the National Assembly’s Health and Welfare Committee, released the results of a comparative analysis of medical treatment data for foreign patients at national university hospitals and data from the Health Insurance Review and Assessment Service (HIRA) on medical support programs for foreign workers and others (2023–2025).
Medical fees are the costs medical institutions charge for treatment and are divided into insurance fees set by law and general fees or international fees set independently by the hospitals. International fees are typically applied to foreign patients visiting for medical tourism.
In response to an inquiry from Rep. Kim’s office, the main campus of Pusan National University Hospital, Seoul National University Hospital, and Chonnam National University Hospital stated that applying international rates to undocumented migrants is their standard practice. In contrast, Yangsan Pusan National University Hospital, Kangwon National University Hospital, Kyungpook National University Hospital, Gyeongsang National University Hospital, Jeonbuk National University Hospital, Jeju National University Hospital, Chungbuk National University Hospital, and Chungnam National University Hospital stated that they apply general rates. Even within Pusan National University Hospital itself, the standards differed between the main campus and its branch hospitals.
The Medical Support Program applies medical aid rates to foreign workers and their families who have difficulty accessing health insurance, marriage immigrants prior to naturalization, and asylum seekers, and covers 90% of total medical expenses, up to 3 million won per visit and 6 million won annually.
Rep. Kim compared outpatient care for 13 primary diagnoses—out of the top 20 conditions by subsidy amount under this program—that each had five or more patients. The total medical costs for 1,021 foreign patients at national university hospitals amounted to approximately 2.06841 billion won, or about 2.026 million won per person. For the 627 patients under the medical support program, the total cost was 775.11 million won, or approximately 1,236,000 won per person—a 1.6-fold difference.
By condition, the disparity was greatest for acute appendicitis. The per-patient medical cost for 21 foreign patients at national university hospitals was approximately 602,000 won, which was 17.5 times higher than that of 41 patients in the medical support program (approximately 34,000 won). For pneumonia, the cost was approximately 615,000 won versus 55,000 won—an 11.1-fold difference; for gallstones, the difference was 6.0-fold; for lower leg fractures (including the ankle), it was 4.1-fold; routine prenatal care was 4.0 times higher, and breast cancer was 2.1 times higher. However, this comparison did not account for differences in patient severity, detailed treatment records, or the type of medical institution.
Representative Kim Yoon stated, “If international fee schedules are mechanically applied uniformly to all foreign nationals, vulnerable groups facing a heavy financial burden for medical care may suffer,” adding, “This is not to deny the necessity of international fee schedules themselves, but rather to propose that application criteria be further refined to take into account the purpose of medical care and economic circumstances.” He went on to emphasize, “In particular, for cases where medical care is highly necessary—such as emergencies, severe illnesses, or childbirth—we need to establish meticulous application criteria to ensure that patients do not forgo necessary treatment due to the cost burden.”
