Most Koreans Back Stronger Government Responsibility for Essential Health Care, But Consensus Lags on Its Concept and Scope

• ■The 2024 National Survey on Essential Healthcare found that 94.9% of respondents agreed that the government should take on more responsibility for essential health care.

• ■Four out of ten respondents defined essential healthcare as ‘all health services covered by the National Health Insurance.’ In contrast, about 56% believed that the scope of essential health care should be determined by policy priorities.

• ■While the survey indicates that the public largely supports a greater government role in the provision of essential health care, there is a lack of consensus on the concept and scope of essential health care.

※ These are KIHASA’s statistics, not official national statistics.

※This press release is based on the following report: Bae, Jaeyong; Seo, Jaehee; Yoo, Jeonghun; Kang, Hee-Chung; & Jeon, Suok. (2024). Current Status and Policy Directions for Essential Health Care and Public Health Care in Korea. KIHASA

KIHASA has published Issue No. 459 of Health and Welfare Issue & Focus, which explores ‘Public Perceptions of Essential Healthcare and Policy Implications.’ The lead researcher is Senior Research Fellow Bae Jaeyong of the Department of Healthcare Policy Research.

Dr. Bae noted that although the term ‘essential healthcare’ has recently emerged as a major policy concept and agenda item, there still seems to be a lack of social consensus on what it entails. He added, “When terms like essential health care―which have limited theoretical or academic grounding, lack social consensus, and are inherently difficult to define through consensus―are used in setting major policy agendas, conflicts among stakeholders are likely to intensify during the policy implementation process.”

In this study, Dr. Bae examined the concept, scope, and public perceptions of essential healthcare and, based on these findings, derived policy implications for the expansion and strengthening of essential healthcare.

A nationwide public perceptions survey on essential healthcare, conducted with 1,005 adults aged 19 to 74, found that 94.9% of respondents agreed that the government should take on greater responsibility for it.

However, there is a lack of consensus among the public on what constitutes essential healthcare.

• ●55.6% of respondents said that the scope of essential healthcare should be determined by policy priorities, consistent with the current direction of essential healthcare policy. Meanwhile, 25% of respondents selected ‘life-saving health services’ as essential, and 18.2% selected ‘health services requiring 24/7 emergency response.’

• ●On the other hand, 41.3% of respondents viewed essential healthcare as ‘the entire range of services covered by the National Health Insurance, or everything except non-covered services,’ effectively equating NHI coverage with essential healthcare.

 Source: “Current Status and Policy Directions for Essential Health Care and Public Health Care in Korea,” Bae, J.-y. et al., 2024, KIHASA, p. 103.

The largest number of respondents selected ‘emergency, trauma, and cardiovascular/cerebrovascular care’ (services for severe conditions requiring a rapid response) as the essential healthcare service the government should take on responsibility for. This largely aligns with current essential healthcare policy priorities.

• ●Furthermore, many respondents viewed ‘maternity, maternal and newborn care, and pediatric care,’ which are also priority areas under the current policy, as essential healthcare fields for which the government should be responsible.

• ●However, many respondents also selected areas such as ‘rehabilitation care, health management for people with disabilities, mental health,’ and ‘management of chronic diseases such as diabetes and hypertension’ as essential healthcare fields. This suggests the need to consider expanding policy coverage to include these areas in future policy development.

Source: “Current Status and Policy Directions for Essential Health Care and Public Health Care in Korea,” Bae, J.-y. et al., 2024, KIHASA, p. 105.

Dr. Bae emphasized that ‘essential healthcare’ lacks a clear theoretical or academic definition, let alone a universally agreed-upon clinical concept. As it is more of a normative and policy concept, it is important to define it through social consensus. He further stressed that achieving the goals of expanding and strengthening essential healthcare requires gathering opinions from a wide range of stakeholders, including healthcare providers and the general public, and building consensus through sufficient communication.