Opinion Leaders` Digest 03-13
Date : April 24, 2003
Author : KIM Jongdai, mookdol@hotmail.co m Professor of the Kyungsan University, Former Director of Planning and Administration, Ministry of Health and Welfares

Financial Integration of the National Health Care Insurance

   People's financial burden of the National Health Care Insurance is growing heavier day by day and the Health Care Insurance financially already fails. Its premium has been increased by 29.56% average per annum from 1998 to 2002, while it increased only 14.56% average per annum up to 1998. Meanwhile its coverage of benefits has been increasingly shrunken. Many a drug has been excluded from the coverage. And the insured own charge has been increased in case of outpatient and medical examination at pharmacy. The insured has to pay at his own expense in case of doctor's consultation fee at 3rd medical institutes. Ceiling has been fixed on the days and duration of coverage.

Government is now controlling medical charges systems and medical examination and treatment expense criteria only to save the financial costs, leading to a rapid worsening level of medical quality and service. This is well known to all of the people to be the result of integration of the health care insurance and separation of dispensary from medical practice.

Financial Integration of the Health Care Insurance, ridiculing peoples
So-called "integration of the Health Care Insurance" has been promoted since October 1998. The author argues that original purpose of the proposed integration was to introduce fair charges of the premium to all the insured by reducing the financial burden to the peoples and by enhancing the benefits.

However, the proposed integration of "occupational insurance" and "regional insurance" had been delayed from January 2000 to January 2003 and again delayed to July 2003, as it would take more time to formulate a single criteria to charge the premium according to the incomes of the wage earners and the self-employed.

However, the Ministry of Health and Social Welfares under the new government is said to have reported to the new president that the financial integration would be effectuated on July 2003 as scheduled and a single fair criteria of the premium would be prepared by 2004. The Ministry will implement financial integration with different criteria of insurance premium charges of the wage earners and the self-employed.

The new government would not reform and renovate the frame and the contents of the Health Care Insurance, even though they fully recognized mistakes of the medical policy by the previous government. This would accelerate the anticipated failure of Health Care Insurance.

Violating the equality
In response to the constitutional petition that the financial integration of the occupational insurance and regional insurance would violate the constitutional equality, the Constitutional Court ruled on June 29, 2000 that, as long as the fair charges of premiums could not be guaranteed, the integration of the Health Care Insurance shall not be allowed constitutionally. But the Constitutional Court ruled as well that the integration of the two different insurances, occupational and regional, would not violate the constitution.

Employers shall not bear the charges of the insurance premium (50%)
The National Health Care Insurance Law stipulates that 50 % of premium of the insured wage earners would be borne by the employers. In case of the regional insurance, the government would support a certain portion of the premium of the insured (the self-employed) within the budget. Once the integration is made, 50% of the premium borne by the employers would be justified no longer at all. This should be borne by the government.
The author warns that our Health Care Insurance is now on the verge of total failure, caused by the integration of medical insurance and mistaken separation of dispensary from medical practices. Operation system of the National health Care insurance should be either adjusted or reorganized.¡á

(April 29, 2003 Abstracted and re-edited in English by JUNG Churle, a CFE Research Fellow, jungchrl@unitel.co.kr)