The National health insurance is involving a lifecycle health protection regime encompassing the prevention of diseases and integrated care ahead of the country entering a super-aged society.
Chmn. Kang Cheong-hee of the National Health Insurance Service (NHIS) declared a “rebooting” of the national health insurance scheme, meaning a fundamental redesign beyond the simple reimbursing of medical care bills, and proposed a macro blueprint to make preparations for the next 50 years.
He called for an AI-based health welfare platform.
Chmn. Kang revealed his management tenets at a meeting in Seoul on Sept. 8 to mark his first 50 days in office in Seoul.
He announced three goals – a shift from a system-oriented paradigm into one based on people’s lives, reforming NHIS into an AI-based health welfare platform, and the establishment of sustainable health insurance through choice and concentration.
Chmn. Kang also held a Q&A session on pending issues.
Chmn. Kang stressed the need for a shift of the health insurance paradigm to one based on people’s lives.
The health insurance scheme has so far been segmented into health insurance, long-term care insurance and regional society integration care.
NHIS envisions organic connection focusing on each individual’s lifecycle.
“As both medical care and nursing are available at care sites, it is significant for patients to receive continuous services at places in which they live, and we have to change the health insurance into a prevention and management-oriented one since ignoring frailty incurs huge social costs,” Chmn. Kang said.
Chmn. Kang picked the establishment of an AI-based health welfare platform as a core means for realizing the goal.
He said NHIS will create a regime in which diseases can be prevented by utilizing the public big data, owned by NHIS and each individual’s health management and care services can be offered at a right time.
He revealed his determination to reform NHIS to a comprehensive health welfare service platform, beyond an institution responsible for simply collecting health insurance premiums and reimbursing medical bills.
Chmn. Kang indicated his plan to intensively restructure NHIS expenditures to secure fiscal sustainability.
He said all businesses will be reviewed from scratch and priority will be determined by looking into whether investments bore fruit.
As for the issue of raising the legal limit of the health insurance premium rate, Chmn. Kang said, “NHIS is not considering raising the health insurance premium rate beyond the legal limit and we will move toward the way in which unnecessary spending is reduced and essential spending is increased within same fiscal revenues.”
As for introducing a special police system to crack down on quasi hospitals, which embezzle health insurance revenues, Chmn. Kang said the NHIS will implement a safe medical care system without infringement on human rights.
Asked whether a drop in the number of patients, caused by friction between the government and medical circles, has led to declining expenditures, Chmn. Kang said it is not and more expenditures have been set aside due to costs related to emergency care and essential medical care support projects.
Chmn. Kang said if investments are not made, then essential medical care in each region will collapse, and it is up to the health insurance body to create an environment in which hospitals can be operated.
Chmn. Kang expressed worry about a freeze over consecutive years.
He said if the health insurance premiums are not raised now, they must be raised by a lot later, so continuous freezes are not desirable.
Concerning a lawsuit pending at the Supreme Court, Chmn. Kang said it won’t have a huge effect on their ability to publicize the side effects of smoking, regardless of outcome of the lawsuit.
Chmn. Kang said the success or failure of policies will be determined in the field, not in a report, and the NHIS will devote itself to lending an ear to voices experts in the field, rather than ending up simply shouting slogans.
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