The Health Insurance System in Korea (11월20일)

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The Health Insurance System in Korea

Shim Myung-han, President of the 90th term
’99 Class, Chungang Univ., Computer Science and Engineering




* The following article would help you understand the status of health insurance system in Korea and present the problems of the system. I strongly recommend you to read the related article precisely and have basic knowledge of health insurance system.

Currently in Korea, only 56% of medical expenditures are covered by national health insurance and the remaining 44% is paid by patients. This percentage is very high compared to other OECD countries. In Luxemburg, people paid only 8% of their total medical costs in 2001, while the rest were paid by public health insurance. In France and Finland, people pay 10% and 20% of medical expenses in a year, respectively. On the other hand, Koreans are provided by low-quality health care owing to the weak financial structure in health insurance. However, Koreans are reluctant to pay either higher taxes or increased health insurance premium1) to improve the quality.

The National Health Insurance Corp. (NHIC) has taken a variety of measures to place itself on the right track2). It is trying to offer a better quality of life to Korean people by operating a reliable and stable health insurance program. The NHIC has successfully gotten over their long-term financial crisis in health insurance fundings by gradually raising its insurance premium. Last year, the NHIC was in the black3) for the first time and had a surplus of about 1.3 trillion4) won. The amount of the surplus could cover the previous losses. The NHIC also announced that they would use the money to expand the coverage of health insurance; by 2007 the NHIC will have lowered the percentage of medical costs paid by patients under 20%. Under this new plan, several measures will be taken to cover the high-cost medical services like magnetic resonance imaging (MRI) and ultrasonic tests, which had not been covered by health insurance program.
Before we discuss the practicability of the NHIC’s new policy, we need to think about the problems caused by the financial difficulty in health insurance fundings in Korea. Usually, the main income of hospitals comes from the charges for consultation, hospital accommodation and food provisions, and the last two are almost covered by current health insurance program. Yet, it does not raise a lot of money. Thus, the effective way of raising money for hospitals is by increasing the number of patients who need consultations; so that hospitals can efficiently attain a good deal of money.

This phenomenon may lead to another problem due to the shortage of the right doctors. Patients are to have high-quality medical services in general hospitals by so-called “selective treatment.” The government established this policy for the public who want to receive better medical services by selecting highly certified and more experienced doctors to treat themselves in general hospitals. However, because of the shortage of these adequate doctors, patients cannot select right doctor for them who would give them proper counsels. What is worse, they could get 3~5 minutes of consultation because each doctor has to treat to approximately 100 patients just in the morning in Korea. In contrast, in European countries, they provide more than 20-minute-long consultation and see less than 20 patients in the morning. It shows that Koreans are provided with poorer medical services than these Europeans.

Now, let us talk about our new policy on health insurance. It has been announced to cover three main serious diseases such as cancer, heart diseases and brain diseases. The government will lower the patients’ shares in those medical costs to 20% to protect the patients’ families from going bankrupt. We pay different amount of money for the medical insurance premium according to the level of one’s income. However, we receive equal medical services from government since it has a characteristic of social security system5). Nevertheless, the rich would eventually receive better medical service by purchasing private insurance programs. The price of private insurances is considered too expensive for ordinary people to purchase. It is obvious that there would be a noticeable distinction of medical services between the rich and the poor. So, Democratic Labor Party even insists that the NHIC should provide 100% medical insurance coverage for subscribers. It sounds very ideal, however, if other expectable problems are not concerned.

In Korea, we should improve the quality of medical services and provide more and better services. At the same time, we need to adjust the medical fee to appropriate level. What level will be appropriate for the public? For whom do we have medical services, the rich or the poor? Should we broaden the private insurance programs to provide better medical services? Should we raise the premium of the rich to provide more services for the poor? Those are the issues that I would like to focus on. With the understanding of my article, let’s discuss the following questions freely.

ming712@gmail.com

<Raised Questions>


1. Have you ever complained about the medical services? When and why?

2. Do you agree with raising medical fees to provide better medical services? Or, do you think that making more private insurance programs is the best way to make medical services better? What could be a solution to make the situation improved? If you know about any example from other countries regarding this, please, share it with other members.

3. As you may know, the dental prosthesis(an artificial substitute for a part of the body that is missing) is not covered by health insurance. But a tooth is crucial for sustaining one’s life. In foreign countries, the dental prosthesis is mostly covered by insurance, but they have to pay a lot for nerve treatment. I think that the NHIC should cover the dental prosthesis, too. However, it takes one of the major income sources away from dentists. What is needed to fix or change dental insurance system?

4. What do you think about the Democratic Labor Party (DLP)’s idea to cover all medical expenditures for all the people in Korea? What kind of benefits or problems can happen? 


이번주 토픽입니다~ 많이 준비해 오세요^^

[whitedew]

으... 길다......갈수록 스터디 가는 발걸음이 무거워질듯...............ㅠㅠ 애쓰셨겠어요~ 감사! ㅋ

[보미니]

정말이네요 그치만 상식공부도 될 거 같네요 ^^

[쉐인]

우리 셋만 하는겨?ㅡㅡ

[Aileen]

이야~~이번주에도 많은 걸 배우고 가겠는걸요^^...

[JOE~]

조은주제 고마워요~ 제목을 "주제(11월 20일)로 바꿔주시겠어요?^^

[광82]

후후... The Health Insurance System in Korea (11월20일) <- 요렇게 봐꿔달라는 이야기인데~~ 번거롭지만.. 한번 더 부탁드립니다...

[뽄드걸]

진정 기네요...ㅋㅋ 수고하셨어요~~~^^

[쉐인]

아하 ..

[whitedew]

아.. 다행히 토론주제는 밑에 4개네요. 오늘은 뽑아서 꼭 읽어봐야지... ^^;

[Pink Gloria^_^]

좀 어려울거 같다는 ㅠㅜ 오늘은 조용히 듣기연습해야겠어요 ㅎ ㅏ ㅎ ㅏ

[신주]

배경지식이 업네요.. 헬스 인슈어런스라!~~~~