Health experts raised concerns that the Korean healthcare system was unsustainable due to population aging, low birth rates, and slow economic growth.
To tackle this problem, the nation’s healthcare should be centered on community and people, they said.
More specifically, they suggested that the government establish a health insurance innovation center, integrate medical services, increase the number of doctors, and divide universal health insurance programs according to provinces and cities.
Rep. Kim Min-seok of the Democratic Party, National Evidence-based Healthcare Collaborating Agency (NECA), and National Academy of Medicine of Korea (NAMOK) held a forum on tasks and measures for a sustainable healthcare system in Korea on Thursday.
At the forum, professor Park Eun-cheol of preventive medicine and public health at Yonsei University College of Medicine said the Korean healthcare system was threatened by population aging, low birth, and slow growth. Then, he proposed innovation tasks to resolve the issue.
The selection of innovation tasks was based on a Delphi survey on 59 experts – 33 from NAMOK and 26 from the Korean Academy of Medical Sciences – from Aug. 6-30.
According to the survey, for the demand side in healthcare, the respondents gave the highest score, 7.8, to policy to improve low birth, 7.3 to intensive management of dementia, 7.1 to mental health and suicide, 6.6 to health improvement for Korean people’s health, 6.5 to integrated management of chronic illnesses, and 6.3 to customized care through ICT.
For the supply side, the experts gave the highest score, 7.3, to the use of data network and AI, 7 to the medical delivery system and payment system, 6.9 to the expansion of health and medical research, 6.9 to re-establishment of the medical institutions’ role, and 6.9 to strengthening health and medical professionals.
In terms of management in healthcare, securing financial soundness in the health insurance program received the highest score with 7.9, followed by a response to public health crises such as infectious diseases with 7.6, reorganization of the government agencies such as the establishment of the health ministry with 7.2, reform of the operational structure of the National Health Insurance Service with 7.0, incorporation of health into all policies with 6.1, and enhancement of local governments’ health competency with 6.1.
Based on the survey results, Park proposed “community-based, people-centered, integrated healthcare” in Korea.
For integrated healthcare, the government should support clinics and provincial hospitals to contribute to enhancing health in their communities.
Also, the government should establish a “health insurance innovation center” to reform the medical delivery and payment system.
In particular, it is important to expand the supply of healthcare professionals and educate them, Park said. To do so, the government should expand the number of doctors, which was once reduced during the 2004-2006 period, and revise the curriculum at medical and nursing schools, he added.
Park also emphasized that the NHIS should be reformed to build a community-based healthcare system.
He criticized the state-run health insurer for lacking motivation for efficient management and collecting insurance premiums ineffectively.
Thus, the NHIS should be operated according to provinces and cities, and their branches should be linked with the support from the Health Insurance Review and Assessment Service (HIRA).
Also, the government should expand state funds for the national health insurance program and distribute the funds by adjusting risks at each branch of the NHIS.
Other experts presented various opinions to make Korean healthcare sustainable.
Woo Bong-sik, director of the Healthcare Policy Research Institute at the Korean Medical Association, said the gradual change was important.
“It is not easy to change the current system. For example, it is not easy to change so-called ‘3-minute patient care’ to in-depth patient consultation like those in the U.S.,” Woo said. “So, the government should develop a long-term plan and proceed in a direction that changes all the Korean people.”
In Korea, 90 percent of the healthcare supply comes from private institutions, but expanding public beds across 70 treatment regions will shut down private hospitals in many areas, Woo said.
In the first half of this year alone, 7 percent of hospital-level institutions closed business, which might negatively affect the supply of medical services.
Won-gon, director of the Hospital Policy Research Institute, suggested the introduction of a clinic accreditation system to enhance primary care, division of roles of tertiary hospitals and general hospitals in severe disease treatment, incentives to prevent patients from moving between regions, improvement of the payment system, the introduction of visiting health services through community care, and AI-backed biomedical innovation.