'Korea's health care system sets example for Iran, Vietnam'

Kim Yong-ik, president of National Health Insurance Service (NHIS), speaks during an interview with the Korea Times at the NHIS office in Yeouido, Seoul, Feb.20. /Korea Times photo by Choi Won-suk

By Bahk Eun-ji, Kim Eil-chul

Kim Yong-ik, president of the National Health Insurance Service (NHIS), is known to be the Moon Jae-in administration's healthcare policymaker. Dubbed “Mooncare,” the government's goal is to expand the coverage ratio of the national health insurance to 70 percent of all medical expenses within the President's five-year term.

The basic concept of Mooncare is expanding the coverage of the state-run health insurance. As Koreans have a strong desire for equality, and equal access to healthcare, Mooncare has been regarded as a policy supported by the majority. According to a survey conducted by the Ministry of Health and Welfare last November, 63 percent responded in favor of the policy.

“Korea has been setting a successful example with its national health insurance system, which many countries such as Iran, Vietnam and Philippines are trying to follow. But the problem is the Korean system cannot cover all medical expenses,” Kim said in an interview with The Korea Times at his office on Yeouido, Seoul.

However, concerns over the system remain after the coverage rate of Korea's national health insurance program inched up by 1.1 percentage points last year. According to data from the NHIS, the country's health insurance service covered 63.8 percent of all medical expenses last year, compared with 62.7 percent in 2017.

In response to the concerns over the relatively lower increase rate, Kim said it was too early to evaluate the policy as it was only introduced in August 2017, and implemented in 2018.

“This year's outcome can be checked only after the first half of 2020 through the process of organizing and analyzing all medical care expenses,” he said. “In the early stages, Mooncare was more focused on expanding the treatments covered by the program.”

There are many treatments that have not been covered by the national insurance program because of high costs, yet the government is aiming to provide insurance for all medical treatments. To reduce the burden of health spending by the public, the government has expanded the scope of insurance-covered diseases significantly, and has taken measures to improve the sustainability of the health insurance system.

“The increase came as the government has been seeking to expand coverage of the state-run health insurance program, especially for the underprivileged, elderly and children as providing equal access to healthcare for the lowest possible cost is one of the government's basic duties as it is directly related to the people's lives.”

He said to achieve Mooncare's goal to boost the country's insurance coverage rate to around 70 percent by 2023, enhancing sustainability and financial stability were necessary.

Korea provides universal healthcare through the National Health Insurance Service (NHIS). It requires all citizens to pay premiums and the insurance covers part of general medical costs. People usually purchase additional policies of private insurance to cover larger medical expenses, such as treatments for major accidents or cancer.

The key to Mooncare is expanding the insurance coverage to include costs for MRIs, ultrasounds, hospital stays and nursing care.

In 2018, the government abolished "optional treatment," which was usually charged when receiving treatment by experienced doctors at large hospitals. In the latter half of 2019, the state-run insurance was expanded to cover fees for more different-sized hospital rooms, emergency room visits and MRIs for specific areas of the body, among others.

“The part that the NHIS has to focus on is to make people as healthy as possible. This will reduce the demand for healthcare in the long run,” Kim said.

Mooncare is not a policy of simply increasing health benefits, such as the mere introduction of health checkups and health incentives.

“We place high importance on early diagnosis and early treatment,” he said.

If a patient misses a chance of early diagnosis and treatment, chances become higher for the illness to become severe. As a result, medical costs will increase, which will also have negative financial effects on the health insurance system.

The government should also increase the number of public hospitals when patients can avoid getting “overtreatment.” Kim said public hospitals can provide a reference for standard care to other hospitals so that the patients do not have to worry about high expenses.

"Through this plan, the Moon administration pledges to continue to build a country where people can receive treatment without having to worry about the expense,” he said.