A Copay plan ensures the financial soundness of national health insurance

Under the second comprehensive plan on national health insurance released on Sunday, the South Korean government intends to charge those who receive outpatient services over 365 times a year 90 percent of medical fees starting this July as part of its efforts to put the brakes on citizens making persistent visits to too many hospitals. After all, last year, the government spent as much as 26.8 billion won handling those who saw a doctor at least once per day, adding up to more than 3,000 times a year. On the other hand, the government will pilot a medical voucher program for young citizens, in which they can get back up to 120,000 won a year if they visit medical centers less than once every quarter.

Fortunately, the government decided to go beyond solely increasing health insurance coverage rates to consider financial soundness. It's better late than never. Indeed, overtreatment issues rose, putting the health financing system at risk as the previous administration abruptly increased health insurance benefits and expanded indemnity insurance policies. For example, the cost of ultrasound and MRI imaging increased ten times to 1.8 trillion won in three years compared to 2018. The number of outpatient visits per year is triple the OECD average. Consequently, the health financial system will see a turn toward a deficit starting three years from now, and the deficit will skyrocket to 1.6 trillion won by 2028.

Financial soundness is essential to reducing shortages of medical professionals in crucial specialties directly related to life or local medical centers, as well as expanding financial support for the socially vulnerable and those with rare and incurable diseases. It is necessary to stop any hole in the health insurance financing system. To this end, health authorities need to consider a co-payment increase for patients with mild conditions such as a cold or require subscribers to fully cover medical costs up to a particular sum on their own, just as in indemnity insurance products.