Healthcare financing reform and the new single payer system in the Republic of Korea: Social solidarity or efficiency?

Kwon, Soonman

doi:10.1111/1468-246x.00150

Cited by 72 publications

(127 citation statements)

References 20 publications

Supporting

Mentioning

127

Contrasting

Order By: Relevance

“…We believe the latter played a more important role than the former in widening mortality gap across educational groups among the working aged, particularly female Koreans. Of course, the commodification of once-publicly owned goods (such as energy, telecommunication, transportation and education) took place in full-scale right after the inception of IMF-proposed adjustment program [24,25]. However, at least the speed of health sector commodification was not accelerated being protected by the Korea National Health Insurance (NHI) system and the increased government spending on health services.…”

Section: Discussionmentioning

confidence: 99%

Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea

Son

Cho

et al. 2012

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

BackgroundsThis study examines social inequalities in life expectancy and mortality during the transition period of the Korean economic crisis (1993–2010) among Korean adults aged 40 and over.MethodsData from the census and the national death file from the Statistics Korea are employed to calculate life expectancy and age-specific-death-rates (ASDR) by age, gender, and educational attainment for five years: 1993, 1995, 2000, 2005, and 2010. Absolute and relative differences in life expectancy and Age-Specific Death Rates by educational attainment were utilized as proxy measures of social inequality.ResultsClear educational gradient of life expectancy was observed at age 40 by both sexes and across five time periods (1993, 1995, 2000, 2005, and 2010). The gradient became notably worse in females between 1993 and 2010 compared to the trend in males. The educational gradient was also found for ASDR in all five years, but it was more pronounced in working age groups (40s and 50s) than in elderly groups. The relative disadvantage of ASDR among working age Korean adults, both males and females, became substantially worse over time.ConclusionsSocial inequalities in life expectancy and ASDR of the working age group across socioeconomic status over time were closely related to the widening of the social difference created by the macroeconomic crisis and the expansion of neo-liberalism in Korea.

show abstract

Section: Discussionmentioning

confidence: 99%

Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea

Son

Cho

et al. 2012

Int J Equity Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…14 Some countries such as Turkey, [15][16][17] South Korea, 18,19 Brazil, Thailand, Ghana, Peru, 20 Estonia, Lithuania, 21 and Indonesia [22][23][24] have adopted this policy to expand the size of the risk pool, and to improve the equity, efficiency, and redistribution of cross-subsidization throughout the entire health insurance system.…”

Section: Policy Contextmentioning

confidence: 99%

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Bazyar¹,

Rashidian²,

Kane³

et al. 2016

Int J Health Policy Manag

View full text Add to dashboard Cite

There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI) schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper.

show abstract

“…Any exemptions or reduced contribution rates among the poor would reduce the degree of regressiveness, and could in principle make contributions progressive. In Korea (Kwon, 2003a) and Taiwan (Lu, 2005) there are exemptions or reduced contribution rates for the poor or otherwise disadvantaged (in the case of Taiwan the poorest 1% of households are fully exempt, and a further 4.5% have their contributions paid in full or subsidized). In Japan, contributions emerge as proportional despite the fact that different insurance plans (there are over 5000 plans under the UHI umbrella) have different contribution rates Campbell, 1995, 1999;Imai, 2002).…”

Section: Who Bears the Burden Of Health Finance?mentioning

confidence: 99%

Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?

Wagstaff

2006

Health Economics

View full text Add to dashboard Cite

The health systems of Japan and the Asian Tigers (Hong Kong, Korea, Singapore and Taiwan), and the recent reforms to them, provide many potentially valuable lessons to East Asia's developing countries. All five systems have managed to keep a check on health spending despite their different approaches to financing and delivery. These differences are reflected in the progressivity of health finance, but the precise degree of progressivity of individual sources and the extent to which households are vulnerable to catastrophic health payments depend on the design features of the system - the height of any ceilings on social insurance contributions, the fraction of health spending covered by the benefit package, the extent to which the poor face reduced copayments, whether there are caps on copayments, and so on. On the delivery side, too, Japan and the Tigers offer some interesting lessons. Singapore's experience with corporatizing public hospitals - rapid cost and price inflation, a race for the best technology, and so on - illustrates the difficulties of corporatization. Korea's experience with a narrow benefit package illustrates the danger of providers shifting demand from insured services with regulated prices to uninsured services with unregulated prices. Japan, in its approach to rate setting for insured services, has managed to combine careful cost control with fine-tuning of profit margins on different types of care. Experiences with DRGs in Korea and Taiwan point to cost-savings but also to possible knock-on effects on service volume and total health spending. Korea and Taiwan both offer important lessons for the separation of prescribing and dispensing, including the risks of compensation costs outweighing the cost savings caused by more 'rational' prescribing, and cost-savings never being realized because of other concessions to providers, such as allowing them to have onsite pharmacists.

show abstract

Healthcare financing reform and the new single payer system in the Republic of Korea: Social solidarity or efficiency?

Cited by 72 publications

References 20 publications

Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea

Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?

Contact Info

Product

Resources

About