South Korea’s Ministry of Health and Welfare has introduced a comprehensive five-year plan aimed at overhauling the national health insurance system to address sustainability challenges amidst a healthcare supply crisis and rapid population decline.
The 2024-2028 plan seeks to address critical issues such as the shortage of medical professionals in certain sectors, overtreatment, and overspending within the national healthcare system. According to the ministry, urgent reforms are needed to tackle structural problems, including regional healthcare disparities and shortages in essential medical services.
Second Vice Minister of Health and Welfare Park Min-soo emphasized the need for substantial investment, stating that over 10 trillion won ($7.47 billion) will be allocated over the next five years to support crucial but under-supplied medical fields.
To address issues with the fee-for-service system, the ministry plans to introduce a public policy fee scheme for essential medical fields such as pediatrics, critical care, mental health, and infectious diseases. Additionally, an alternative payment model will provide incentives for high-quality and cost-efficient care, aiming to align financial incentives with patient outcomes.
The ministry also aims to improve health equity by enhancing cooperation between local medical institutes and national university hospitals. Designating national university hospitals as “responsible medical institutions” is part of the plan to ensure necessary medical care is accessible across different regions.
Furthermore, measures will be implemented to prevent overtreatment and overspending. Patients will receive information on treatments not covered by insurance to make informed choices. The ministry also plans to incentivize responsible use of the healthcare system, with adjusted rates for individuals based on their utilization patterns.
A notification service will be launched to provide individuals with information on their healthcare use and medical expenditure every three months.
These initiatives reflect the government’s commitment to ensuring the sustainability and effectiveness of the national health insurance system in South Korea.
