South Korean healthcare system sustainability concerns

The Korean Medical Association (KMA) has raised several concerns regarding the financial sustainability and structural efficacy of the national healthcare system.

Initially, the KMA warned of potential instability caused by tightening insurance claim reviews and the possibility of a ‘two-track regulation.’ This involves private insurers implementing stricter standards for inpatient payouts alongside government efforts to move certain treatments under ‘managed benefits,’ which the KMA suggests could limit patient access. Additionally, the association urged against freezing 2027 health insurance premium rates, noting that an aging population and expanded coverage requirements necessitate increased government subsidies to maintain essential medical services.

Subsequently, the KMA shifted focus toward reforming the elderly outpatient fixed-sum system. The association argues that the current structure causes out-of-pocket expenses to spike sharply once certain thresholds are met, potentially leading seniors to delay or avoid necessary care. To support this reform, the KMA has been conducting nationwide visits to regional branches of the Korea Senior Citizens Association, alongside public signature campaigns and perception surveys, to gather data for policy proposals to the National Assembly and the Ministry of Health and Welfare.