The purpose of this paper is examine existing health care systems of the aged in Korea. The term health care system is used in this paper in a very broad sense to integrate also non-professional subsystems like the family. Two questions will be focused: What are the main problems in the health care systems of the aged in Korea? Secondly, what measures should be undertaken to reduce or prevent these problems? The specific topics what will be discussed are: 1) demographic trends of aging in Korea; 2) general health status of elderly; 3) medical policy; 4) community health care system, and 5) family care. This discussion therefore identifies the problems and solutions. In order to describe the health care systems of the Korean elderly, we rely on data on the aged from various sources, such as ethnolographic materials, government statistical data, surveys done by Korean gerontologists, newspaper reports and so on.
The existing data on the health care systems of the aged in Korea indicate a number of problems. The significant problems concerning health care systems of Korean elderly and recommended solutions are:
First, there are many more older people who wlll suffer chronic disease since the population aged 75 and over has been increased continuously and will be a much larger group in the future. More health services will be needed but resources are lacking. More burdens will fall on the family unless institutions are created to help. The role of the family in health care and illness of the elderly should be defined. The need for home health care serivices or the need for institutional places will rise. Also, the shifting of the burden of health care of the aged from the family to the public is an issue.
Second, Korea needs to develop health care programs which can reach the majority of the aged. The elderly tend to use less of health services than other age groups. Only 3.6% of the Korean elderly were treated under the medical insurance in 1983. Moreover, health care systems of the aged are varying in according to sex, geographic location (rural/urban) and socio-economic status. The distribution of medical and health care services has favored males, urban areas, and higher socio-economic class. It is not only a problem of health but also one of social justice for the majority.
Third, the negative reinforcement of portraying physical and mental illness as the normal course of aging is deeply embeded into Korean culture. Also, Korean elderly do not have correct knowledge of nutrition. Old people tend to accept their illness and to have a low expectation of services. Preventive geriatrics should be practiced. More geriatic care personnel, information and training should be used with old people. This needs great involvement of community.
Fourth, no establishment has been made for the concept of medical assistance for the aged. Current medical policy does not meet the needs of the eldery´s health care. This has not been designed for the elderly population. To plan health development for the aged, a national committee on aging should be established. The committee should study, examine, and guide the elderly with reference to their needs and desires for their health care.
Fifth, Kroea is lacking in reliable demographic, economic, health, and other data on the aged population which are necessary for effective planning and implementation process for helth care of the aged. Without reliable information, most decisions on policy or programs for the elderly seem to be based on hunches or political expediences. Under such conditions, effective health care is impossible. There must be a national effort to promote and support accelerated research on the health care of the elderly.
Sixth, aging is not national priority. Unless the political and social leaders recognize the value of the health care for the aged, it may never be a priority.
Health care for the aged has been constrained by various problems, political, cultural, economic, and social. However, health needs of the aged lack political visibility and relative value. Korea has been postponing the development of social services for the elderly - - most notably retirement pensions, social security, and medical care. Korea needs the development of a national scheme of health care programs for the aged. There is no doubt that it has to be tackled both in the interests of economic development and of human welfare. We have to recognize that the problem of health is a question of achieving human dignity and its concomitant rights.
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