- Healthcare Reform. (image from technorati.com)
We’ve talked about the new population of migrants that have entered Korea here and how the changing demographics have created a concern for the government. Improving the immigrants’ access to healthcare is one of my primary concerns during my stay in Korea, but before we talk about the barriers of the system, we must first understand the system itself. So let’s begin!
Korea has a universal health care system, provided by the compulsory National Health Insurance (NHI). Every resident of Korea is eligible, with foreign residents receiving the same health benefits as citizens. At least that is the intention. It should also be noted that there are regional disparities in healthcare services. Most private facilities are in urban areas, and 90% of physicians are in cities.
Let’s backpedal a bit and discuss the three arms of the Korean healthcare system.
- National Health Insurance Program (NHIP)
- Medical Aid Program
- Long term Care Insurance Program
National Health Insurance Program
A mini history lesson to begin:
1963– The same year General Hospital was introduced to soap opera viewers, the “Medical Insurance Act” was established by South Korean law makers. This act was the first health insurance law created, and allowed for the creation of medical insurance companies.
1977 – The first social insurance program, Employee Scheme, was introduced which allowed for the stepwise coverage of small sized firms. This is when they created a plan to have universal health care.
1989 – There was a health insurance program crated for not only urban areas but also include the self-employed. It took them but 12 years to get to this stage.
2000 – All health insurance societies were integrated into a single insurer: NHIP
2006– over 96.3% of people covered under national health insurance.
The remaining 3.7% of people fall under the Medical Aid Program. The funding for the National Health Insurance program comes from 3 locations:
- Contributions: 5.08% of a resident’s income is dedicated towards health insurance. If they are work under a company, the company pays for 50% of this fee.
- Government subsidies: This is 14% of the total annual projected revenue
- Tobacco surcharges: 6% of the total annual projected revenue
Medical Aid Program
This program was established in 1978 for lower income families. In this plan the government pays for all of the medical expenses when the patient cannot afford to. After 2004 this program was expanded to also insure patients who had rare and chronic diseases and well as for children. Though this program is officially funded by a cooperation of central and local government, the money is often insufficient. Thus they receive money from the NHIP when necessary.
Long Term Care Insurance Program
As the average age of the population has been increasing, so has the average life span. As a result, Korea’s 65+ demographic increases not only in the amount per age group, but also in the number of age groups. Though it has been tradition in Korea for families to take care of their elders, it is increasingly becoming a burden in modern households. In order to ease this burden, the Long Term Care Insurance Program was created, which covers 3.8% of the elderly. This program is funded by the insured, government subsidies, as well as co-payments by the beneficiaries.
What’s written above is how the healthcare system in Korea was created and how it is intended to work. While we will talk about the barriers and issues of healthcare access for foreigners and immigrants, it is important to note that 92.1% of medical facilities are in urban areas, while only 79.7% of the population lives in urban areas. Thus there is a discrepancy of 12.4% automatically built into the infrastructure of the system. While the government controls the healthcare system itself, individual medical facilities are private and therefore profit-seeking. The natural consequence is that certain demographics will be ignored in the process.
References 1.Lee, Jong-Chan. “Health care reform in South Korea: success or failure?.”American journal of public health 93.1 (2003): 48-51. 2. Ministry of Health, Welfare, and Family Affairs Annual Report2006, 2007, 2008 3. National Health Insurance Act. 4. South Korea Health Care System, Dr. Young Joo Song, Japan Medical Association Journal, May-June 2009
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