Hyoung-Sun Jeong

Korea’s National Health Insurance—Lessons From The Past Three Decades

This study presents data on health care spending in South Korea in the three decades since 1977, the year its national health insurance--enacted in 1963--was enforced. National health insurance in South Korea is currently a single-payer program (that is both publicly and privately financed) that pays for privately provided health care. Universal coverage was achieved in 1989. As a result, the household share of total national health spending fell from 87.8 percent to 54.6 percent during the three decades, and the out-of-pocket share dropped from 87.2 percent to 38.0 percent. Although covered services have gradually expanded, benefits remain relatively low, and public funding is limited, leaving beneficiaries with relatively high copayments. Coupled with the fact that the government manages the schedule of fees paid to providers, the health care share of gross domestic product was a low 6.3 percent in 2007. An analysis such as this may be of particular interest in middle- or low-income countries contemplating expansions of coverage or undertaking insurance reforms.

Trends in Scale and Structure of Korea's Health Expenditure over Last Three Decades (1980-2009): Financing, Functions and Providers

This paper introduces statistics related to the size and composition of Koreas total health expenditure. The figures produced were tailored to the OECDs system of health accounts. Koreas total health expenditure in 2009 was estimated at 73.7 trillion won (US

Impact of the Purchasing Price Reimbursement System for Insurance Drugs upon the Health Insurer`s Financial Situation

57.7 billion). The annual per capita health expenditure was equivalent to US

Health care reform and change in public-private mix of financing: a Korean case.

PPP 1,879. Koreas total health expenditure as a share of gross domestic product was 6.9% in 2009, far below the OECD average of 9.5%. Koreas public financing share of total health expenditure increased rapidly from less than 50% before 2000 to 58.2% in 2009. However, despite this growth, Koreas share remained the fourth lowest among OECD countries that had an average public share of 71.5%. Inpatient, outpatient, and pharmaceutical care accounted for 32.1%, 33.0%, and 23.7% of current health expenditure in 2009, respectively. A total of 41.1% of current health expenditure went to hospitals, 28.1% to providers of ambulatory healthcare (15.9% on doctors clinics), and 17.9% to pharmacies. More investment in the translation of national health account data into policy-relevant information is suggested for future progress.

Divergence in the development of public health insurance in Japan and the Republic of Korea: A multiple‐payer versus a single‐payer system

The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer`s financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer`s financial situation given that the current compulsory separation between doctor`s prescribing and pharmacist`s dispensing is irrevocable.