In the last 30 years, Korea has gone from having a limited infrastructure and medical coverage, to building a health system characterized by universal coverage of its inhabitants and consolidating one of the highest life expectancies (83 years old).
According to indicators such as the Health Care Index, in the last five years Korea has positioned itself among the two best health systems, surpassed only by Taiwan, being awarded as the best worldwide in 2017, 2018 and 2021.
Despite of having one of the lowest levels of health spending (in relation to GDP) among Organization for Economic Co-operation and Development (OECD) countries (8.4% in 2020), the per capita copayment for care is 15% above the average, and experienced a strong increase of 5% between 2015-2019, which is why private insurance plays an important role in complementing its financing. Other problems that have presented this system are lengthy wait times, even in emergency situations. To continue let’s take a closer look at the system:
South Korea’s public healthcare system is referred to as National Health Insurance (NHI). It is of extremely high quality and is provided to all citizens as well as all residents that living in Korea for a period of more than six months. is administered by the National Health Insurance Service (NHIS) and the care it covers is reviewed by the Health Insurance Assessment and Review Service (HIRA).
Public health care of this system is funded through a combination of payroll taxes, government subsidies, outside contributions, and tobacco surcharges. An average of 5% of the payroll is deducted from a worker’s monthly earnings, divided between the employee and the employer. Self-employed people’s contributions are taxes determined based on income and families, while low-income families are exempt from monthly contributions to the health system. It is estimated that tobacco provides approximately 6% of the financing of the system and the government contributes around 14%.
At the subnational level, regional governments manage regional medical centers and other medical facilities according to local needs. Each municipality has a Public Health Center, which offers basic services such as medical check-ups, vaccinations, prenatal care, and basic medical care. In addition, Sub-Health Centers can be established where additional services are required. HIRA has data on 46 million patients regarding diagnosis, treatment, medical history, and prescription drugs, which represents 90% of the total population in Korea.
The NHI covers a suite of benefits that focuses on curative care, including diagnosis, treatment, traditional medical care, emergency care, pharmaceuticals, and dental care. However, it also includes some preventive care in the form of medical checkups and cancer detection.
By other side, private health insurance plans perform complementary functions to the NHI plan. Due to the high copays associated with the NHI, it is estimated that 87% of households in South Korea have private health insurance, whether it be against cancer, accidents, or other types of expensive illness. In 2019, self-pay accounted for 30.25% of healthcare spending, well above the OECD average of 20%, the UK’s 17%, Canada’s 14% or 12.9% from Japan.
An important challenge that the system experiences refer to health disparities in medical services in rural areas. This is because most private medical facilities are located in urban areas. About 90% of doctors are concentrated in urban areas, while only 80% of the population lives there; but this still leaves those in the countryside without the same top-notch access to healthcare that is standard throughout the country.
On the one hand, Korea, like other developed countries, is experiencing considerable demographic and age change. It is becoming an aging society and the significant decline in birth rates presents a challenge and financial burden to the Korean government and the workforce that helps finance it.
In addition, until now the system has focused on curative medicine – rather than preventive – which is why rapid demographic change, emerging lifestyle risk factors and the rise in chronic diseases mean that public health prevention should be a political priority for the short and medium term. Among the major causes of mortality include cerebrovascular disease, Alzheimer’s disease, ischemic heart disease, lung, and liver cancer, although the prevalence of some infectious diseases, notably tuberculosis, remains high compared to peers of the OECD.
In summary, we see that the effectiveness of the South Korean health system has led them to obtain great international recognition; however, as in most countries, it faces challenges such as the habits changes of its inhabitants and the decline of the active population as a result of the low birth rate; in another instance, having medical support from public and private sectors for some sectors increases the efficiency to supply the needs of its population and raise its life expectancy. Undoubtedly, this is another lesson that governments in develop can implement to optimize and expand the quality of their health systems.
References / Bibliography:
- Morales Estay Pablo. El sistema de salud en Corea del Sur. Biblioteca del Congreso Nacional de Chile / BCN. Departamento de Estudios, Extensión y Publicaciones Programa Asia Pacífico. (Chile 2022)
Health Insurance and Healthcare in South Korea Explained: https://www.internations.org/south-korea-expats/guide/healthcare#:~:text=The%20South%20Korean%20Healthcare%20System%20Explained&text=Healthcare%20in%20South%20Korea%20is,Western%20and%20Eastern%20treatment%20options.
- Korea Social Security: https://youtu.be/3hl5ok2cwBk
- Health information South Korea: https://fundacionio.com/viajarseguro/paises/corea-del-sur/informacion-sanitaria-corea-del-sur/
- Living in South Korea Santander Trade: https://santandertrade.com/es/portal/establecerse-extranjero/corea-del-sur/expatriarse?actualiser_id_banque=oui&id_banque=35