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Extension of public health care system

Country: 
Südkorea
Partner Institute: 
Department of Health Policy and Management, School of Public Health, Seoul National University
Survey no: 
(3)2004
Author(s): 
Soonman Kwon
Health Policy Issues: 
Public Health, Organisation/Integration des Systems, Zugang
Current Process Stages
Idee Pilotprojekt Strategiepapier Gesetzgebung Umsetzung Evaluation Veränderung/Richtungswechsel
Implemented in this survey? ja nein ja nein nein nein nein

Abstract

The proposal of the MOHW (Ministry of Health and Welfare) to extend the public health care system aims to improve access to medical care, extend programs on prevention and health promotion and contribute to health cost containment. The proposal was presented after the new Government took office in 2003.

Purpose of health policy or idea

The Ministry of Health and Welfare (MOHW) has made a proposal to extend the public health care system. It plans to increase the percentage of public sector beds in total beds from current 15.2% to 30% by 2008.

Government expects that the extension of public health care system provides better (more equitable) access to medical care. Out-of-pocket payment at the point of services is still high despite the universal social health insurance, and public hospitals charge lower prices than private hospitals do. The Ministry of Health and Welfare expects that public hospitals focus more on prevention and health promotion and contributes to cost containment. Ministry of Health and Welfare's proposal includes plans to strengthen the role of national university hospitals, increase support for the infrastructure of local government hospitals and extend public health centers.

Main points

Main objectives

Improve access to care, strengthen health promotion and contain costs.

Type of incentives

More funding

Groups affected

the poor and vulnerable

 Suchhilfe

Characteristics of this policy

Innovationsgrad traditionell recht innovativ innovativ
Kontroversität unumstritten recht kontrovers kontrovers
Strukturelle Wirkung marginal recht fundamental fundamental
Medienpräsenz sehr gering neutral sehr hoch
Übertragbarkeit sehr systemabhängig recht systemabhängig systemneutral

  • If implemented, the extension of public health care system will introduce a big change on Korean health care delivery, which has been dominated by the private sector.
  • The relative performance of public vesus private health care systems is still in controversy in Korea. Although public health institutions are better than private hospitals in providing medical care to the poor, they suffer from inefficient management. Whether public hospitals contribute to health promotion and containment of national health expenditure is still uncertain too.
  • Since the benefit coverage of social health insurance is still limited with high out-of-pocket payment, priority may have to be given to extending the public sector role in health care financing rather than in health care delivery system.

Political and economic background

There was a change of government in early 2003, and the new president is interested in increasing the role of public sector in health care.

Change of government

new president

Purpose and process analysis

Current Process Stages

Idee Pilotprojekt Strategiepapier Gesetzgebung Umsetzung Evaluation Veränderung/Richtungswechsel
Implemented in this survey? ja nein ja nein nein nein nein

Origins of health policy idea

The new president as well as health policy community supporting him has placed emphasis on the role of public sector in health care. They believe that the public health care system is superior to the private system in terms of prevention, health promotion, cost containment, and providing better access to medical care for the poor,

One of the major barriers to health care reforms in the previous government were physician strikes. Dominance of the private sector made the healthcare system vulnerable to physician strikes. Those experiences of previous health care reform reinforce the preference for the public health care system.

Approach of idea

The approach of the idea is described as:
renewed:

Stakeholder positions

Providers do not support the idea of extending the public health care system because of the potential impact on competition. However provider group has not made official opposition to the government proposal.

The Ministry of Finance and Economy is not supportive of the proposal made by the Ministry of Health and Welfare because of the burden on government budget.

Progressive civic groups support the idea of extending the public health care system.

Influences in policy making and legislation

The extension of the public health care system does not require legislation.

Legislative outcome

n/a

Adoption and implementation

The Ministry of Health and Welfare's proposal to extend the public health care system has not been adopted yet. So far, there was no increase in the budget allocated to public health care systems.

Monitoring and evaluation

N/A

Expected outcome

N/A

Impact of this policy

Qualität kaum Einfluss wenig Einfluss starker Einfluss
Gerechtigkeit System weniger gerecht four System gerechter
Kosteneffizienz sehr gering neutral sehr hoch

If implemented, extended public health care system is expected to contribute to equity in access to care. Although public health care institutions tend to provide less unnecessary care (than private hospitals), they can suffer from managerial inefficiency. Therefore the impact of the extension of public health care system on overall cost efficiency is rather uncertain.

References

Sources of Information

Internal reports of the Ministry of Health and Welfare

Author/s and/or contributors to this survey

Soonman Kwon

Empfohlene Zitierweise für diesen Online-Artikel:

Soonman Kwon. "Extension of public health care system". Health Policy Monitor, 21042004. Available at http://www.hpm.org/survey/rok/a3/1