Health Care and Health Insurance

Health Care and Health Insurance in South Korea: An Overview

Written By Jessica Keralis

South Korea has mandated universal health insurance since 1989, and it integrated all health insurance companies into one national program in 2000. The National Health Insurance (NHI) Program provides coverage for nearly everyone who lives in the country.

The insurance premium is about 5 percent of a person’s salary, of which the employee and the employer each pay half; for those who are self-employed, the premium is calculated based on income, property, and standard of living.

The program is funded by premium payments, government subsidies and tobacco surcharges. When seeking medical care, individuals are charged a co-pay (a set percentage of the total cost of care) depending on the type of facilities used. The cost of each visit or procedure is set by the government.

Advantages

The advantages of a single-payer system are obvious. Patients have the freedom of choice when choosing their doctor, clinic or hospital and are not restricted to “in-network providers.” Doctors can also choose whether to work in a private or public (government-funded) facility. A single insurance program that covers the entire population and regulates costs also helps to keep essential care affordable. There is no pressure to cost-compare in the middle of a medical emergency to get the best price for needed medical care, and it does not cost USD 35,000 (KRW 35 million, or about GBP 23,000) to fix a broken arm (such as when my husband broke his in a car accident in 2010).

Challenges

Unfortunately, no system is perfect. The most commonly lamented (and frequently featured in K-dramas) shortcoming is that the system only covers primary care and essential services, so supplemental insurance must be purchased in order to cover elective procedures, such as chemotherapy. The system is also struggling with increasing costs as Korea’s population ages, and fewer people are paying into the system as the elderly population grows and requires more care. “Doctor shopping,” a practice indirectly encouraged by the system, also drives up costs; patients prefer to go to expensive hospitals for minor ailments, and hospitals and clinics find themselves in a “medical arms race” to provide cutting-edge technologies and therapies in order to compete with one another for clients.

Your Rights

For all its shortcomings, enrolling in the NHI is crucial to ensuring that your needs are met and your rights are respected, particularly for foreign nationals. Unfortunately, it is also one of the most common things foreigners are cheated out of. Migrant laborers are often simply not provided with insurance and in some cases are forced to pay for their own care out-of-pocket. Hagwons frequently hire English teachers as “independent contractors” and provide them with poor-quality private insurance to avoid paying the required contributions (as well as the pension contributions). Such practices are against the law.

If you suspect that your employer is withholding these benefits from you, you should file a claim with the Labor Board. The GIC has staff members who can help with this matter.

Jessica Keralis has a Master of Public Health and four years of experience in the field of public health. She is currently working as an epidemiologist. Feel free to suggest future health article topics by contacting her at jmkeralis@gmail.com. All views expressed here are her own and not those of any employer.