[Editorial] Policies That Threaten Nat’l Health Insurance
There are policies and debates sprouting up all over the place that threaten the basis of the national health insurance program, and it makes you have serious doubts about the Participatory Government’s medical policy. It was just recently that they decided to permit for-profit medical institutions in the Songdo economic zone and in Jeju province, and now there is talk about private sector loss insurance and reducing the amount of money for health insurance that comes from the national treasury, and that is cause for worry. The people behind those ideas work for economy-related government ministries, and they emphasize the economic benefits that would come from making medical care a private industry and having private medical insurance be more prominent. The problem with that is that it would make the rich richer and the poor poorer in the area of medical benefits by uprooting the foundation of health insurance, and it would work against reducing socioeconomic disparity.
The medical sector is a typical area where reasonable public regulation gets justified because the efficiency of the market does not have its effect. If private medical insurance is going to have a place as something that satisfies the diverse medical desires of the people, then the government has a lot of work to do in terms of standardizing medical insurance plans and reducing discrimination against insured persons, and improve things like the cost comparison program. It is clear that the expansion of private medical insurance without first making sense of the government’s unorganized programs will seriously threaten stable national health insurance. If things develop so that private medical insurance replaces non-paying areas of health insurance, that will, in the end, lead to increased use of medical services, swelling national medical expenses, less complete coverage, and other economically and socially undesirable results. The complete implementation of health insurance needs to be the prerequisite for unleashing private medical insurance.
The plan to make national treasury support for health insurance more efficient needs to respect the social consensus on the framework for that, and it has to be discussed from the perspective of maintaining the appropriate amount of total spending. The decision to give government support for 50 percent of what local medical insurance pays is a social contract agreed on after much discord. The focus of government policy needs to be about finding ways to maintain expenditures as much as the economy can handle it over the long term (instead of reducing spending) while seeing to it the money is used efficiently and never wasted. That will require a restructuring of insurance fees, policy designed to remove the pharmaceutical price bubble, and structural reorganization of a medical delivery system that induces cost.
There is a lot about national health insurance in Korea that needs fixing, but among developing nations it is among the more successful. Companies and economy-related government ministries need to stop thinking simply of health insurance as a labor expense, and take note of the effect it has in lowering the labor costs of business as a whole. If insurance fees of between 4 and 5 percent keep workers healthy, that can be a considerable contribution to a company’s competitiveness. You have to be on constant guard for the possibility that policies for putting more of medicine on the market, which would destroy the public character of health insurance, would not lead to skyrocketing fees that would be a serious financial burden for companies and for society as a whole. In a country like Korea, where the medical system is highly commercialized, failing to take the effects a policy could have into account is something that could lead to an irreversible situation. People need to take a careful look at the case of the United States, where business and society as a whole are seriously ill because of the excessive commercialization of medicine.
The government wants to increase coverage to 70 percent, and that is significant in the sense that it will mean greater long-term corporate and national competitiveness and for what it will do for social unity. Lately, however, you are made to wonder if it was really that serious about the plan. Making the medical industry competitive is fine, but we hope to see the government, through concrete policies, demonstrate its firm determination to make health insurance better serve the public.
The Hankyoreh, 30 March 2006.
[Translations by Seoul Selection]