(Unofficial translation)

Fellow Koreans,

On this meaningful day marking the 30th anniversary of the adoption of a universal national health insurance system, I am pleased to present achievements from the implementation of the policy to expand national health insurance coverage on its second anniversary.

There was a time when people took out newspaper ads to look for their lost national health insurance cards. The average low-income citizen, who was not a civil servant, school teacher or employed by a large company, could not sign up for national health insurance. As their health care costs were three times higher than those covered by the health insurance, they sometimes had to borrow someone else’s health insurance card illegally to see a doctor.

Adoption of the universal national health insurance system made it possible for everyone to hold a health insurance card and receive basic medical treatment. All of this happened just some 30 years ago.

National health insurance, along with economic development and democratization, is yet another legacy of success our people achieved together.

In 1963 when the Medical Insurance Act came into effect, Korea’s annual per capita income was no more than US$104. Employer-based national health insurance was first introduced in 1977 when the country’s per capita income surpassed US$1,000 for the first time. Universal national health insurance was initiated in 1989 when Korea’s per capita income first exceeded US$5,000. In 1999, following the foreign exchange crisis and IMF bailout, medical insurance – which had been split between the employer- and region-based subscribers – was unified into national health insurance.

Among the OECD member states, there are still only 18 countries, including Korea, that have universal national insurance programs in place. Korea successfully adopting universal national health insurance 12 years after starting a national health insurance system was an unprecedented achievement, completed in record-breaking time. 
Before the national health insurance scheme was introduced, approximately 40 percent of ill patients were not able to visit clinics or had to suspend treatments for lack of money, but now everyone can afford to go to a hospital. With the patient’s share of medical expenses decreasing and a greater number of people getting easier access to medical services, the Korean people are enjoying health that is comparable to that of those living in advanced countries. In terms of such key indicators as life expectancy, infant mortality and cancer survival rates, Korea ranks near the top among the OECD member states.

Medical technologies and insurance review and assessment know-how have been able to grow at the same time. Korea’s medical technologies are highly rated around the world, and many countries are looking to Korea for cooperation in the health care sector. An increasing number of countries are learning and importing Korean-style hospital and health insurance systems.

Over the past 30 years, national health insurance has steadily grown in the spirit of mutual aid by which burdens are shared in accordance with individual abilities. Dedicated medical professionals and businesses have made it possible for the country to be equipped with a world-class health insurance system and medical services. I want to take this opportunity to extend my heartfelt respect and gratitude. 

Fellow Koreans, 

We are now facing new challenges. 

With the average life expectancy extending, new types of diseases and chronic illnesses have increased. As new medical technologies are developed, costly treatments not covered by health insurance are also on the rise. Public expectations of medical standards are steadily rising. At the time of the launch of my Administration, the nation’s health insurance coverage rate had remained just above 60 percent, far below the OECD average of 80 percent.  

Although we live in the era of universal health insurance, patients with serious or rare diseases and their families still face huge burdens because out-of-pocket expenses are high. Therefore, the livelihoods and lives of those patients as well as their relatives often collapse. 

Moon Jae-in Care, aimed at enhancing health insurance coverage, was launched to guarantee the entire population lifelong health, building on the achievements and limitations within the 30-year-old health insurance system. 

We look to move beyond a health insurance system that aims to help people keep a minimum level of health in order to achieve one that guarantees maximum protection of health. The overriding goal is to ensure that national health insurance by itself is sufficient to keep each and every citizen healthy and safeguard the future of all families. 

“Guaranteeing lifelong health for the entire population” is a policy preparing healthier lives for our children and brighter futures for us all as we face longer post-retirement periods. On top of this, this new policy is based on the confidence that the nation’s strength and finances have grown sufficiently large. In other words, although we can’t raise our health insurance coverage rate to match the OECD’s average of 80 percent right now, we must and can increase it to reach at least 70 percent.

My fellow Koreans, 

In line with the promise made two years ago, my Administration, together with the people, has striven to build a country free from the burden of medical expenses where any disease can be treated without anxieties. 

As a result, given the data currently available from general hospitals and other higher medical institutions, the health insurance coverage rate sharply soared from 62.6 percent in 2016 to 67.2 percent in 2018. The goal of Moon jae-in Care is to raise the rate to 70 percent before the end of my term.  

In particular, Moon jae-in Care is very helpful for patients who have to shoulder high medical expenses. Those with serious ailments now pay less than a quarter of what they did before the introduction of the policy. 

Out-of-pocket payments for care from a doctor requested by the patient were abolished, and insurance coverage was expanded to include stays in upper-grade hospital rooms up to double-occupancy. We are also gradually expanding coverage for essential examinations such as MRIs and ultrasounds as well as for indispensable treatments for emergency patients and those with serious diseases. 

Couples trying desperately to have children as well as pregnant mothers at high risk are now eligible for assistance. Benefits have also increased for the elderly and children, who are easily susceptible to diseases.
 
Health insurance has started to cover such dental procedures as filling children’s cavities and making dentures for seniors. Children who need hospitalization and severe dementia patients can receive treatment at costs now half of the previous expenses. Health insurance coverage was also expanded for traditional Korean medicine treatments.

Medical costs should not bring a household to financial ruin. The burden on low-income families has been further reduced. Low-income households can now secure medical treatment anytime throughout the year and their total annual out-of-pocket expenses will never exceed 1 million won. Households with an income level in the lower 50 percent can receive as much as 30 million won in medical care assistance.        

As a result of these efforts, the people’s medical expenditures were reduced by a total of 2.2 trillion won in the period between January 2018 and April of this year.  

However, we will not be content with the achievements here. Burdens from medical examinations and treatments still not covered by health insurance will be reduced going forward. Health insurance coverage will be expanded for all necessary medical treatments to ensure that health insurance can fully support health and happiness for everyone.  

Health insurance will immediately begin covering ultrasound scans of the prostate beginning in September, MRI scans of the abdomen and chest in October and ultrasound scans for the uterus and ovaries in December. 

Health insurance coverage will also be expanded for diseases related to the spine, joints and eyes as well as materials needed for surgeries and treatments to ensure that individuals do not have to forego essential treatments or examinations because they are not covered. 

In addition to enhanced coverage, we will make efforts to provide safer and higher-quality medical services. 

For essential medical services directly related to the lives of the people such as emergency care, intensive care and trauma centers, we will strive to secure a sufficient number of medical professionals and high-quality healthcare nationwide by improving the fee-for-service system set by the national health insurance and strengthening other related supports. 

We will help children grow up healthy by actively fostering children’s hospitals in different regions.        

The Government’s pledge is firm. If the Government carries out the pledge as planned by 2022, the health of each and every person will be guaranteed, the burden of medical expenses will be minimized, and the sustainability of health insurance will be secured at the same time.  

Fellow Koreans,

The world is taking note of the Republic of Korea. This can be credited to the strength of the people who advanced democracy and social welfare along with economic development.  

This is not something that came our way like a miracle one day; rather it has been achieved by the people together who lived diligently day by day, year by year, dreaming of a better tomorrow. Thus, it is even more magnificent, and I am always proud of it. 

Moon Jae-in Care, the measures to strengthen health insurance coverage, will advance further in step with the lives of each and every citizen. 

To bring about the era of the entire population having guaranteed health coverage for life, I’m looking forward to the people supporting this policy to protect everyone’s health and nurture hope by pooling everyone’s strength. Moon Jae-in Care can succeed without fail. 

Thank you.