J Korean Med Assoc.  2011 Nov;54(11):1118-1120.

Is free medical care possible?

• Park IS

Abstract

Free medical care is currently a highly debated issue in Korea. However, from a practical point of view, 'completely free' medical care is impossible. Last year the National Health Insurance Corporation (NHIC) reported a huge deficit of up to 1.3 trillion in Korean won, which is the largest deficit in the past 10 years. NHIC expenditures are skyrocketing for many reasons: drug overuse, very expensive new drugs or devices increasing geriatric population and survivors of cancer or chronic illnesses, expanding insurance coverage for new diagnostic tests, drugs, neonates, rare diseases, disabilities, and cancer, occurrence of new diseases, increasing number of doctors, moral hazard, and wasting of resources due to the duplication and counteraction between modern medicine and Oriental medicine. What, then, should we do to provide partially free medical care? We need to reduce expenditures for drugs and increase health insurance premiums. Korean health insurance premium currently low compared to that of other countries in Organization for Economic Co-operation and Development. It is also necessary to introduce the concept of a health tax, in which healthy individuals with a high income pay higher premiums while sick or low-income individuals pay lower premiums. Expanding public health coverage such as vaccinations, regular health surveillance programs, and education on health promotion should be implemented. Private health care insurance can be introduced carefully with close monitoring. The last and most important recommendation is that society must become more ethical and transparent. Korea is entering a new era as a developed country and as a result a welfare system, including medical care is notoptional but is mandatory in some part. However, even a partially free medical care is going to be possible only if the entire health care system is operated in an ethical and efficient way for maximal utilization of limited resources while avoiding moral hazard and waste.

Keyword

Free medical care; National health programs; Medical expense; Health care; Aging society

MeSH Terms

Chronic Disease
Delivery of Health Care
Developed Countries
Diagnostic Tests, Routine
Health Expenditures
Health Promotion
History, Modern 1601-
Humans
Infant, Newborn
Insurance
Insurance Coverage
Insurance, Health
Korea
Medicine, East Asian Traditional
National Health Programs
Public Health
Rare Diseases
Survivors
Taxes
Vaccination

Reference

1. Kang SW, Kim HK, Kim S, Woo SH, Park S. A study on public attitudes to social cohesion and welfare policy. 2011. Seoul: Presidential Committee on Social Cohesion, Korea Institute for Health and Social Affairs.