Development of National Health Insurance and Policy Agenda in Korea

CHAPTER 1 Development of National Health Insurance
Socioeconomic development and conditions for the introduction of NHI
Previous stage of NHI
Implementation of NHI
Implementation of regional health insurance and universal
Health insurance integration and evaluation
The pathway to integration
Change of medical aid program (MAP)

CHAPTER 2 Financing and Risk Pooling
Classification and management of financial bearers
Public financing for health
Health insurance financing in Korea
NHI Financial management in Korea
Financing by voluntary health insurance (VHI)

CHAPTER 3 Purchasing and Benefit Package
Purchasing theory
Insurance benefits
Non-covered services
Insurance benefits and payment system
Pharmaceutical pricing and reimbursement system

CHAPTER 4 Health Care Delivery System
Development of health resources
Hospital development
Lack of health planning and expansion of hospital bed supply
Vulnerability of primary care and unbalanced distribution of medical resources between regions
Provision of public health services
Separation of the prescribing and the dispensing of drugs

CHAPTER 5 Future Policy Agendas
Establishing the ideology of NHI
Adoption of a need approach
Establishment of health planning and patient referral system
Establishment of purchaser’s role
Enhancement of responsiveness
Preventing the commerciality of health care institutions
Establishment of the concept of so-called ‘public health care’
Introduction of contract system for health care institutions
Management system and stewardship
Reform of premium imposition
Management of health care quality
Improvement of drug management
Reform of health care delivery system