미국 의사소유병원의 성장과 규제의 시사점

In Korea, non-medical personnel and for-profit corporations are prohibited from establishing medical institutions. Similarly, the U.S. adheres to the Corporate Practice of Medicine Doctrine, which restricts the ownership of medical institutions to licensed medical professionals and prohibits non-medical individuals and for-profit corporations from owning such institutions. However, when the commercialization of healthcare intersects with concerns over monopolization and anticompetitive practices, the U.S. has placed a stronger emphasis on preventing monopolization and promoting competition. As a result, for-profit hospitals have become a significant part of the healthcare system in the U.S. Physician-owned hospitals, a subset of for-profit hospitals, expanded rapidly due to exceptions made to regulations aimed at prohibiting doctors from referring patients to facilities they own. However, this growth raised issues related to conflicts of interest and anticompetitive conduct, such as over-treatment driven by profit motives. In response, the U.S. government implemented measures to restrict the establishment of new physician-owned hospitals and excluded them from Medicare and Medicaid. Strict regulations under the Patient Protection and Affordable Care Act (commonly known as “Obamacare”) have significantly reduced the number of physician-owned hospitals. In contrast, 92% of all medical institutions in Korea are physician-owned. While for-profit hospitals are banned, physician-owned medical institutions dominate Korea’s healthcare system. In Korea, the right to profit from operating medical institutions is exclusively reserved for medical professionals. These physician-owned institutions display high levels of profitability, driven by strong economic incentives, the absence of a structured healthcare delivery system, excessive competition, the expansion of non-covered services, and an increase in the volume of services provided. Considering the situation in the U.S., where the Corporate Practice of Medicine Doctrine has been largely symbolic and where anticompetitive practices and conflicts of interest in physician-owned hospitals have become subject to regulation, it is necessary to reassess Korea’s current system. In Korea, the system grants a monopoly on establishing medical institutions to medical professionals but lacks sufficient regulation on the operation of these physician-owned institutions, raising potential concerns about unfair methods of competition.