Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage
Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage
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DOI：
10.1093/heapol/czn037
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发表时间：
2009-01-01
影响因子：
3.2
通讯作者：
Kwon, Soonman
中科院分区：
文献类型：
--
作者：
Kwon, Soonman
韩国在1977年为大公司的产业工人引入了强制性的社会健康保险，并逐步将其扩大到个体户，直到1989年覆盖所有人口。韩国30年的全民健康保险可以就保健筹资政策中的关键问题提供宝贵的经验教训，这些政策目前正面临许多旨在实现全民保健覆盖的低收入和中等收入国家，例如：税收与社会健康保险；人口和福利覆盖；单一方案与多方案；购买和提供者支付方法；以及政治和政治承诺的作用。韩国的全民健康保险成功地调动了医疗保健资源，迅速扩大了人口覆盖面，有效地汇集了公共和私人资源，为所有人口购买了医疗保健，并控制了医疗保健支出。然而，私营医疗服务提供者的主导地位、人口的迅速老龄化以及与私人医疗保险有关的公私混合也带来了挑战。
South Korea introduced mandatory social health insurance for industrial workers in large corporations in 1977, and extended it incrementally to the self-employed until it covered the entire population in 1989. Thirty years of national health insurance in Korea can provide valuable lessons on key issues in health care financing policy which now face many low- and middle-income countries aiming to achieve universal health care coverage, such as: tax versus social health insurance; population and benefit coverage; single scheme versus multiple schemes; purchasing and provider payment method; and the role of politics and political commitment. National health insurance in Korea has been successful in mobilizing resources for health care, rapidly extending population coverage, effectively pooling public and private resources to purchase health care for the entire population, and containing health care expenditure. However, there are also challenges posed by the dominance of private providers paid by fee-for-service, the rapid aging of the population, and the public-private mix related to private health insurance.