This country case study was prepared under the aegis of Seoul National University, which collaborated with the P4H Network to introduce the history of social health protection and health financing reforms in the Republic of Korea. This study aims to provide an analytical review of milestones and determinants of reforms in health care in the Republic of Korea through 2021.
This document consists of five chapters:
- Chapter 1 The single payer national health insurance system: This chapter explores when the institutional changes took place, what interests and conflicts appeared, and how the Republic of Korea achieved population coverage and the merger of the national health insurance. The determinants and outcomes of the economic crisis and social reforms are examined as they relate to governance structure.
- Chapter 2 Health financing reforms in the 2000s: This chapter provides details the reforms to the Republic of Korea’s social health insurance system. The payment system contains a fee for service system, diagnosis related group payments, a pay for performance model and per diem payments. The section on coverage expansion covers key changes in national health insurance policies: a co-payment ceiling, co-payment rate, and exemption, positive list system and a refund mechanism for medicines
- Chapter 3 Social health protection: This chapter addresses medical aid for those living in poverty, financial support for catastrophic health expenditures, personal assistance and sickness and maternity benefits.
- Chapter 4 Long term care insurance: This chapter explores how population aging affects the sustainability of the social health insurance system and the introduction of new funding mechanisms for the care of older people.
- Chapter 5 Way forward: This chapter provides the policy implications of the Republic of Korea’s social security system as the country works towards universal health coverage and social health protection.