The health insurance scheme was introduced in 1977 and expanded its coverage to the whole population in July 1989. It therefore took only 12 years to cover all people with the health insurance scheme. In the administrative form of the program, Korea adopted the society-based system. But, It has been lasted the severe dispute between decentralization and unification on the subject of managerial problems of National Health Insurance since 1980. As a result, the health insurance program for the regional self-employed and for government & private school employees were merged in October 1998 and the National Health insurance System in Korea is supposed to be integrated in July 2000.
The purpose of this paper is to analyze the issues and suggestions in unification dispute and to examine reasonable recommendations in the integration of the National Health Insurance System in Korea
Six points can be stressed in relation to the successive settlement of the integrated health insurance program. First, Equity in premium burdens between the self-employeds and the industrial workers should be guaranteed. To do so, it is essential to assess actual income of the self-employed people. Second, It should be taken actions to assure the financial stabilization, such as the increase in the contribution rate and the elevation of collection rate. Third, Various measures should be taken in order to improve the efficiency in the management of health insurance program including the reduction of administration costs. Fourth, the operating principle of the integrated health insurance program should be changed toward a low co-payment and proper benefit system. Fifth, as health expenditures ave been growing markedly since the enforcement of National Health Insurance System, policy measures should be developed to deal with cost containment including the change from the current fee-for-service point system to the prospective payment system such as DRG and global budgeting. Finally, the integrated health insurance program being settled, the government should take an interest in the efforts to improve various conditions in terms of efficiency, equity, and quality
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