According to National Health Insurance Service’s website (http://www. nhis. or. kr), National Health Insurance in Korea’s history dates back to 1966. Medical insurance was instituted in 1966, but enforcement was held in 1977, and the medical insurance system to target large companies with 500 or more employees was implemented. The medical insurance had been expanded gradually since then. Finally, the health insurance system had been conducted in 1989 for all the people who have been to apply health insurance.
In 1998, 227 regional health insurance unions and health care industries of officials and teacher medical insurance were integrated into the National Medical Insurance Management Corporation. In July 2000, National Health Insurance Management Corporation and employee medical insurance associations (139 societies) were INTEGRATED.
30TH ANNIVERSARY OF THE NATIONAL HEALTH INSURANCE SERVICE (NHIS) IN 2007 AND integrated National Health Insurance in 2010 were celebrated. Korean national health insurance is one of the most exemplary models in the world because the national health insurance system is the shortest period of time to expand health insurance for all citizens, and hundreds of health insurance industries were integrated into the a single insurance corporation.
Efficiency of management by integrated national health insurance is dramatically improved, and assurance of public health insurance has been enhanced. The structure of the Korea Medical Insurance System Except in some public hospitals in South Korea, personal physician owned hospitals. The national health insurance finances through general taxes, all Koreans must be insured mandatorily.
Private insurances supplement a part of insurance payment not covered by the national health insurance (balance bill). The core of this system, the National Health Insurance Service is owned by the government. As mentioned above, all Koreans living in Korea is insured Korean Health Insurance System 3 automatically. The only exception is people who are protected by the government, and they are supported by complete welfare system and don’t pay additional taxes. Those people are very poor, refugees, child-headed and holder of important intangible cultural heritage and national merits.
All people who are insured are required to pay extra taxes. There are two options to pay such taxes in which are employees who have health insurance are deducted from their salary and the company such as premium and people who are not in career pay directly to NHIS. The health insurance premiums through two paths are exactly the same, but not nearly the same amount. Medical insurance amount is determined in the same manner as taxes, a high income earner pay much more than low earner. The most important function of NHIS is that allocates all costs of the health care process by the law.
Excluding the cost of specific surgery or costs, because all medical procedures must be specified by the law, its works are very broad. In particular, because NHIS determines the cost of prescription drugs, the drug costs are incredibly low. How is Koran healthcare service operated? Patients go to see a doctor. After diagnosis, the patient has to pay the remaining low portion of the medical fee, excluding the deducted fee from NHIS, and then receive a prescription. Then physicians and pharmacists should claim to NHIS for the medical service fee and the total amount of drug costs.
Although many parts of medical related are covered by health insurance, also private health insurance companies exist in Korea. Despite the covering, certain diseases such as cancer and chronic diseases are still a costly burden to middle-class in Korea because those diseases include the selective surgery, and request long LOS while the patient is not working. Therefore, many people have private health insurance for not covered by NHIS or wages during treatment. Advantages The advantages of the health care system in Korea are very clear.
First, anyone can take medical Korean Health Insurance System 4 services in anywhere they want. This cannot be overemphasized and is a huge strength. Anyone in Korea can take medical service in a relatively small cost even if they have any ills. Koreans usually see a doctor with even a cold. Accordingly, a more severe case of the disease is often detected early.
If can pay deductibles, anyone can see any physicians. In Korea, if want to see the best doctors, it is easy thing to go (most of these doctors are in Seoul). In addition, the entire system itself is really cheap. No one likes to pay taxes, but many Koreans complained this system.
However, according to Issue and Focus (Korea Institute for health and social affairs, 2009), about 6. 4% of GDP in Korea is expended for the medical field, and this is significantly row rate compared to other countries (about 10% of GDP in Europe and Canada, and horribly 16%ofGDPintheU. S. ). Weaknesses No matter how even small money, it comes out of someone else’s bank account. So that is where the money comes from? First, benefits of Korean Medical Insurance are not the same range of European countries.
In particular, the most difference between diseases which are expensive treatments such as cancers is clearly prominent. Compared to European countries and Canada, because Koreans pay generally small for health insurance, NHIS tends not to spend the money for even health insurance coverage. Because illness like Cold can be treated easily, this is not a big problem for the basic disease. However, surgery, involves more a lot complex diseases such as chronic disease or cancer, can cause problems when caught. In this case, they cannot have full coverage (That’s why most Koreans consider having the private insurance for cancer).
The national health insurance does not cover the disease which is supposed to be treated for many years. According to the Blog (Kim, 2007), the European countries and Canadian national health insurance cover 90% of the total cost of treatment, but Korean Medical Insurance System Korean Health Insurance System 5 supports about 55% of the total cost of treatment. Bankruptcy due to medical expenses of the middle class occurs as much as the U. S. however, in low-income families without private health insurance would be financial burden due to the cost of cancer treatment.
Secondly, medical doctors don’t earn a lot of money in Korea. Of course medical doctors have rich life than in other occupations, they earn about half of the doctors in Europe and Japan and the quarter of American doctors. However, even the best doctors happen because NHIS reimburses a bill for medical services to doctors. When give same medical treatment, Korean medical physician claim 1/8 of the cost in the United States and 1/4 of the cost in Europe and Japan. The disadvantage affects significantly on health care. There are three main ways to earn money. 1) More patients to be examined.
2) Higher outside procedure of the scope of NHIS performed. 3) Find another way to make money look. Medical doctors in Korea can get a lot of incentive if patients care were randomly a lot. It is called in a mocking word “five minutes practice”.
The patients complain not to receive appropriate care. The doctors tend to encourage the patients to get expensive treatment because the doctors can get the incentives. For example, South Korea is a world leader in cesarean delivery. Newborn cesarean rate is 43%. It is often recommend because a doctor can charge a lot of health insurance reimbursement by cesarean section.
There are inpatient beds, CT scanners, and MRI in Korea more than the OECD average because inpatient care and the technically developed scanners can be charged a lot. Doctors also encourage longer length of stay in hospital than expected. Critique I think Korea medical insurance system is far from perfect, but Koreans believe that the benefits overwhelms loss. When viewed health insurance system as a whole, substantially, there are many benefits compared with the payment. First, the complaint, “five minutes counseling or talking Korean Health Insurance System 6 with a physician”, is truly not big problem.
By providing incentives to doctors who meet a lot of not severe patient, Korean medical insurance system can prevent serious diseases. I believe that Americans who are not insured can be willing to overcome the problem such as “5 minute counseling” if they can see physicians in very low cost. Although Koreans also have a complaint about waiting time when they visit the best hospital in Korea (there is no big different payment between local hospitals or physician offices and well-known hospital), I believe that uninsured Americans are willing to visit the best hospitals in the U. S. even if it takes long waiting time for very low cost.
The problems in Korean health insurance system are less serious than other countries. In fact, in Korea, because there is a independent legal entity, responsible for overseeing the entire health care system, it is much easier to have systemic solutions against systemic problems. Some people grapple the issue to where Korean health insurance system only supports 55% of the total health care cost. It is serious matter to people aim to socialized health insurance. However, for fiscal conservatives who sympathize with the uninsured, such an aspect can be attractive balance.
Corruption in health insurance system is still a problem in Korea, but certainly, the National Health Insurance Service in Korea is an amazingly efficient, and well-operated. Korean Health Insurance System 7.
REFERENCES History of National Health Insurance Service in Korea. Retrieved February 11, 2014 from http://www. nhis. or. kr/static/html/wbd/g/a/wbdga0203. html. Korean Institute for Health and Social Affairs. (2009, p. 2). The health insurance cost in Korean compared to OECD countries. Kim, S. (2007). Europe, America, and Korea’s medical insurance comparison. Retrieved February 15, 2014 from http://grands. egloos. com/1189992.