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Video Description

Type: KIHASA Research Introduction Series

Topic: Our Research: Health Insurance Research

Speaker: Shin Young Seok, Senior Research Fellow, KIHASA

Transcript

Greetings! My name is Shin Young Seok from the Department of Health Care Policy Research at KIHASA.

We human beings need care from the cradle to the grave. Among the various forms of care, the one that is directly linked to our lives is health care. How How the maximum amount of health care services can be provided to the entire population in the most efficient way is what our Health Care Research Department is mainly concerned with. Now, let me tell you more about what we do at our research department.

First, when people need to use medical facilities, they should be able to afford them. It would be best if individuals didn’t have to pay out-of-pocket costs. However, due to the limited resources in our society, doing away with out-of-pocket payments is not feasible. Instead, what we can do is expand the service coverage to a level at which people can afford healthcare services. When making decisions about what to expand in the coverage, for example, whether to include MRI in the coverage or to prioritize physical therapy, we base such decisions on a national consensus. Of course, the premise here is that all expansion decisions are made within the confines of our financial capacity.

Secondly, we study the delivery of health care services.

Wouldn’t everyone prefer to receive care from a top-tier hospital?

However, receiving services at such a facility may invlve higher financial costs. Thus, we focus on finding ways to make the utilization of these services more efficient. For example, when you have a mild illness, it is advisable for you to visit a local clinic first. If that doesn’t work, you can obtain a referral and seek care at a higher-level hospital. Developing a system to facilitate this process is one of our research topics.

Thirdly, we study matters concerning the compensation of healthcare providers.

Currently, Korea has a payment system where services are unbundled and paid for separately. This setup creates an incentive for healthcare providers to offer as many services as they can. If this system continues, the ensuing financial burden will escalate dramatically. That is to say, this system is not sustainable in the long run. In our research department, we are trying to figure out what methods of compensation would be sustainable in a way compatible with national sentiment and at the same time optimize service utilization.

Fourthly, the healthcare sector in Korea has inherent limitations on the supply side. Presently, private providers account for 90% of healthcare services in Korea, while the public sector covers the remaining 10%. In Europe, where the world’s first health insurance was introduced, the situation is exactly the opposite. There, public providers are responsible for 90% of services, with the private sector comprising only 10%. It is worth noting that for private players to enter a market to make an investment, there must be profit potential. This is evident in the context of COVID-19, which serves as a prime example. Another compelling case is that of Captain Seok Hae Kyun. Trauma patients are relatively rare. That’s why the private sector hardly invests in this field. However, when matters of life and death are involved, shouldn’t the government assume responsibility for such incidents? Addressing the design of public health and ensuring a healthy future is also a focus of our health policy research department.

Fifth, there’s a financing issue that we are studying.

Korea has in place both health insurance and long-term care insurance. As of 2020, Koreans paid 6.99% of their income in health insurance premiums. What level of premiums would be sufficient to cover the entire health care costs in the country? Should contributions be based solely on income, or should factors such as property and cars also be considered? How can we achieve a national consensus on these matters? How do other countries handle their health insurance? We ought to consider these in shaping the future of our health insurance policies.

In addition, we must address the matter of healthcare professionals who deliver vital services, such as doctors, pharmacists, and nurses. What is the optimal number of hospital beds? What is the desired level of healthcare quality, and how can we improve it? Additionally, we cannot overlook the rapid advancements in health technology and the ever-changing IT landscape. The link between healthcare and welfare has recently emerged as a major agenda. Taking all of these factors into consideration, our research department is primarily dedicated to finding ways to provide the Korean people with the finest healthcare services at the most cost-effective rates.

At the Department of Health Care Policy Research at the Korea Institute for Health and Social Affairs, we are committed to continuously seeking solutions to address emerging problems and challenges to ensure the health of all nationals as we adapt our research to the ever-changing environment. Thank you.