Korean Medical Association warns of healthcare financial instability

The Korean Medical Association (KMA) is raising concerns regarding the financial sustainability of the national healthcare system and the tightening of insurance claim reviews.

Regarding varicose vein treatments, private insurers such as Samsung Fire & Marine and Hyundai Marine & Fire are implementing stricter review standards for inpatient insurance payouts following a Supreme Court ruling. The KMA warns that this could lead to a ‘two-track regulation’ where insurers restrict inpatient coverage while the government simultaneously moves to include such treatments under ‘managed benefits,’ potentially limiting patient access to care.

Separately, the KMA is urging a responsible decision on the 2027 health insurance premium rates. As the Health Insurance Policy Deliberation Committee prepares to decide on rates, the KMA expressed concern over potential freezes. They argue that with an aging population and new coverage expansions for items like nursing care and hair loss treatments, freezing premiums without increasing government subsidies—which currently sit at approximately 14.4% against a legal standard of 20%—will jeopardize the long-term stability of essential and critical medical services.