Republic of Korea health system review
How to Cite this publication
Kwon S, Lee Tj, Kim Cy. Republic of Korea Health System Review. Vol.5 No.4. Manila: World Health Organization, Regional Office for the Western Pacific, 2015.
Economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes in the Republic of Korea. Overall, the health status of the Korean population is better than that of many other Asian countries.
The Republic of Korea achieved universal health coverage of its population in 1989, just 12 years after the introduction of social health insurance. In the early 2000s, it introduced two major reforms: merger of insurance societies into a single insurer system and the separation of medicine prescribing and dispensing. Health care is financed through National Health Insurance covering the entire population.
Health care delivery relies heavily on private providers, who induce demand for new, but sometimes not cost-effective, services and technologies not yet included in the national health insurance benefit package because they are not subject to fee regulation. As in other private sector dominated delivery system, the referral system in the country does not function well, and patients prefer tertiary care hospitals. Tension between private providers and the Government (and the national health insurance system) has been substantial, and health care providers have been a stumbling block to health care reforms such as the prospective payment system.
Despite universal coverage of the population, financial protection and high out-of-pocket (OOP) payments have remained a key policy issue. OOP payments still required in social insurance include co-payments for covered services and full payment for services not included in the benefits package. Patients pay 20% of the cost for insured services in inpatient care, and differential cost-sharing is applied for outpatient care, depending on the level of health provider. Although national health insurance provides some protection mechanisms, such as exemption from co-payments for the poor, reduced co-payments for catastrophic illness like cancer, and a ceiling on cumulative OOP payment depending on income, high OOP payments have remained a key policy issue.
The rising inequity since the 1990s and the rapidly ageing population have had a big impact on health care system and population health outcomes. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.