Is Universal Health Insurance Superior in Terms of Healthcare Payment? Estimating Financial Burden of Healthcare in Korea: 2009 to 2019

Lee, Changwoo

doi:10.1177/00469580221135957

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Jung, Kwon, and Noh (2022) [ 25 ] emphasized that national health insurance (NHI) is more effective than PHI in reducing CHE. Finally, Lee (2022) [ 26 ] concluded that the financial burden of healthcare in Korea is regressive, with 30% of households spending over 10% of their income on medical expenses. These findings highlight the need for policy improvements to ensure equitable financial protection.…”

Section: Discussionmentioning

confidence: 99%

The impact of the expanded health insurance coverage policy on healthcare spending: evidence from Korea

Ji,

Lee,

Choi

et al. 2024

Int J Equity Health

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Background South Korea’s National Health Insurance (NHI) system pursues universal health coverage, but it has not been able to alleviate patients’ financial burden owing to limited coverage and a high proportion of out-of-pocket expenses. In 2017, the government announced a plan to strengthen universality by providing coverage for all unincluded services, expanding coverage, and alleviating household financial burden. We aimed to evaluate the effect of “Moon Care” with a focus on changes in health expenditures following policy implementation, and to provide empirical evidence for future policies to strengthen the NHI system’s universality. Methods Using data from the 2016 and 2018 Korea Health Panel (KHP), we established a treatment group affected by the policy and an unaffected control group; we ensured homogeneity between the groups using propensity score matching (PSM). Subsequently, we examined changes in NHI payments, non-payments, and out-of-pocket payments (OOP); we performed difference-in-differences (DID) analysis to evaluate the policy’s effect. Results Following policy implementation, the control group had a higher increase than the treatment group in all categories of health expenditures, including NHI payments, non-payments, and OOP. We noted significant decreases in all three categories of health expenditures when comparing the differences before and after policy implementation, as well as between the treatment and control groups. However, we witnessed a significant decrease in the interaction term, which confirms the policy’s effect, but only for non-payments. Conclusions We observed the policy’s intervention effect over time as a decrease in non-payments, on the effectivity of remunerating covered medical services. However, the policy did not work for NHI payments and OOP, suggesting that it failed to control the creation of new non-covered services as noncovered services were converted into covered ones. Thus, it is crucial to discuss the financial spending of health insurance regarding the inclusion of non-covered services in the NHI benefits package.

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Section: Discussionmentioning

confidence: 99%

The impact of the expanded health insurance coverage policy on healthcare spending: evidence from Korea

Ji,

Lee,

Choi

et al. 2024

Int J Equity Health

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“…The average household in Korea had 1.6 private health insurance policies in 2018, up from 1.3 in 2011. 23 In the new millennium, Korea is concerned about emerging healthcare issues. Rising healthcare expenditures, the shortage of medical professionals, and the demographic and recommendations that can be fully respected in the possible application of these experiences in the Croatian healthcare system.…”

Section: Korean Healthcare System Outcomes a N D Challengesmentioning

confidence: 99%

Possible Applications of the Korean Experience in the Development of Croatian Healthcare System

Bejakovic,

Družeta,

Kwon

2023

Science, Art and Religion

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Healthcare is a very important and complex system in every country, and a huge expenditure for it is not a guarantee of successful prevention and cure of illness. Around 98% of the population in Croatia is covered by the public health insurance system, which is an admirable achievement. Healthcare institutions in Croatia are organized on three levels. Primary healthcare levels are community healthcare centers, healthcare facilities, institutions for home healthcare, and organizations for palliative care. Healthcare services on the secondary level include hospitals, treatment, and outpatient centers. Tertiary-level healthcare is realized in clinics, mostly clinical hospitals and clinical hospital centers. Serious challenges of the Croatian health system are the neglected role of primary healthcare, a vast concentration of healthcare institutions in the big cities, suboptimal implementation of artificial intelligence (AI) in disease diagnostics and medical treatment, a lack of structured data, and the long waiting list. Croatia is reforming its healthcare system, and in this process, an adequate adjustment of Korean experiences and the best practices can be more than useful. The part dedicated to the situation in Korea particularly provides information on the Korean healthcare system, outcomes, and challenges, as well as explains the importance of digital automation in the healthcare service and a push for Nationwide Health Screening in Korea.

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“…Lee 1 estimates the financial burden of healthcare, including the quantum of insurance premiums, in Korea using a unique panel dataset on health insurance and utilization. The authors find that out-of-pocket spending has declined steadily from 2009 to 2019, with the public payer shouldering more of the expenditure burden.…”

Section: Introductionmentioning

confidence: 99%

Does Universal Health Insurance in Korea provide a Lesson for U.S. Health Care Financing?

Phan

2023

INQUIRY

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This note provides a commentary on Lee, C. “Is Universal Health Insurance Superior in Terms of Healthcare Payment? Estimating the Financial Burden of Healthcare in Korea: 2009 to 2019.” INQUIRY, 2022, 59:1-8. Lee, using a unique data set, shows that the Korean single payer system is regressive, despite previous attempts to increase public expenditures. The policy recommendation, to improve access by making public payments even more progressive to household income, is examined. This note concludes that making health expenditures progressive to household income does not solve the root cause of the demand for health care, a key factor in health care access, nor can the policy implications generalize to the multi-payer U.S. system.

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Is Universal Health Insurance Superior in Terms of Healthcare Payment? Estimating Financial Burden of Healthcare in Korea: 2009 to 2019

Cited by 4 publications

References 9 publications

The impact of the expanded health insurance coverage policy on healthcare spending: evidence from Korea

The impact of the expanded health insurance coverage policy on healthcare spending: evidence from Korea

Possible Applications of the Korean Experience in the Development of Croatian Healthcare System

Does Universal Health Insurance in Korea provide a Lesson for U.S. Health Care Financing?

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