Korea ranks high among the OECD member countries with a high out-of-pocket share. In 2006, the government implemented in full scale the policy of extending the health insurance benefit coverage. Included in the policy are lowering the out-of-pocket share of patients of serious case and expanding the medical bill ceiling system to mention just a few. This study proposes to confirm effectiveness of the benefit extension policy by identifying changes in'out-of-pocket expenditure as a share of the ability to pay'and'incidence rate of catastrophic health care expenditure' of each individual household as manifested before and after the benefit extension policy was implemented. The 1st and 3rd year data from the Korea Welfare

a provision for medical institutions to report items, amounts, and details of uncovered medical expenses to the Minister of Health and Welfare was newly established in the Medical Law. This paper aims to estimate the scale and trend of out-of-pocket expenditures for uncovered medical items; to review the government's plans as well as related literatures for the management of uncovered medical items; and to gather opinions at expert meetings. Of the total current health expenditures in 2019, household out-of-pocket was 47.5 trillion won (30.3%), and "out-of-pocket excluding cost-sharing" was 26.3 trillion won (16.8%). The decrease in household out-ofpocket burden over the past 2 decades has been replaced by the increase of private health insurance premiums, suggesting that the policy has not been sufficiently connected to the burden relief of low-income households. Whether covered or uncovered, a medical item is located at a point in the continuous spectrum between necessity and selectivity. It is most logical to classify medical items according to the size of "necessity of treatment, " and determine the level (height) of co-payment rate accordingly. A medical item changes its position on the necessity-selectivity spectrum. It is a limitation in terms of classification. Suggestions: First, "medical items for which the treatment necessity is confirmed" should be covered by public health insurance, subject to quality management and differential co-payment rates. Second, "items with relatively weak treatment necessity", currently not covered, should be switched to coverage once their therapeutic natures are confirmed, though their co-payment rates are set high in order to induce "cost-conscious" medical use of patients. Third, even in the case of "items remaining uncovered", policy measures as follows are required from the perspective of consumer protection: informed consent, data submission, and monitoring when they are provided together with covered items, etc.

Asia/Pacific 2018 documents the progress made, but also sheds light on remaining gaps to improve the health of populations and, in particular, to reduce inequalities in access and improve quality of care. While access to care for the most marginalised groups has improved, women in low-income households living in rural areas constantly report significant problems in accessing needed care, due to distance and financial reasons. Addressing these gaps is necessary to achieve more inclusive economic growth and to deliver on the Sustainable Development Goals (SDGs), in particular SDG 3 to ensure healthy lives and promote well-being for all at all ages. This report presents the latest comparable data and trends on key aspects of health and health care systems in selected Asia-Pacific countries. The indicators provide a snapshot of health status, determinants of health, health care resources and utilisation, health expenditure and financing, and quality of care in the region. As countries strive to achieve universal health coverage, these indicators help measure their progress towards the SDGs. For example, the report points to an increase in household out-of-pocket expenditure for health goods and services in lower-middle and low-income countries. It also signals that policies to improve affordability of medicines can enhance coverage and improve access in the region. More than ever, clear, relevant and well-targeted data and indicators of health outcomes and health care are essential to assist policy makers in formulating evidence-based policies targeting health system improvements. Comparing health system performance across countries is important to identify good practices, foster dialogue on progress, encourage knowledge sharing and mutual learning between countries. It will also help policy makers identify priority areas for action to strive for health systems committed to people-centred care. We hope that the data reported in this publication will help policy makers make further progress towards improving coverage, access and financial protection of populations across the Asia-Pacific region.