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KMID : 1170320230290020055
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Korean Journal of Health Economics and Policy
2023 Volume.29 No. 2 p.55 ~ p.86
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Projecting the National Health Insurance medical care cost using Micro-simulation model
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Hwang In-Uk
Lee Yun-Kyung
Lim You-Na
Lee Tae-Jin
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Abstract
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In Korea, the National Health Insurance (NHI) expenditure is expected to rapidly increase due to population ageing and the government’s policy of expanding the health insurance coverage, as estimated in previous studies using component-based or macro models. Compared to such models, the micro-simulation model has advantages in reflecting dynamic changes in individual-level determinants of medical care cost, population structure, and policy effect on individual behaviors. In this study, we designed a micro-simulation model for estimating the National Health Insurance medical care cost between 2019 and 2065 and produced detailed projection results using the Korean Health Panel Survey data. Our results suggested that total NHI medical care cost increased to 150 trillion Korean Won (KRW) in 2065, of which 2/3 was cost incurred by older adults aged 65 and over. Once we incorporated effect of the health insurance coverage expansion policy, the total NHI medical cost in 2065 increased to 206 trillion KRW. Additionally, projected medical care cost in 2060 approximately corresponded to 6% of projected GDP in Korea. We also showed that our results are subject to the key components of the model, including the period for parameter estimation, population projection scenarios, the presumed relationship between changes in health insurance coverage and changes in individual medical cost, by suggesting that the NHI medical care cost increased to 16% of the projected GDP if we change the parameter estimation period and the assumption on insurance coverage-medical care cost relationship.
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KEYWORD
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Micro-simulation model, National Health Insurance, medical care cost projection
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