The Republic of Korea achieved universalhealth coverage in 1989, twelve years after the introductionof mandatory health insurance for employees in largecorporations. Political legitimization of the authoritarianregime and rapid economic growth contributed to the rapidextension of health coverage. Most health care providers areprivate. In 2000, all insurance funds were merged into asingle insurer, which improved the efficiency of riskpooling and equity in contribution payments. The singleinsurer system also provided the national health insurancesystem with the opportunity to strengthen its purchasingfunction. Nevertheless, the Korean health system faceschallenges. Policy priority was given to populationcoverage, with low contributions and a limited benefitspackage, which resulted in insufficient financial protectionof the insured. The rapid increase in private-sectorproviders has helped the supply readiness for universalhealth care, but has also engendered challenges to financialsustainability due to profit-seeking behavior and theoverprovision of care, which was further exacerbated byfee-for-service payments. Korea’s health system also needsto be further reoriented to respond to the rapid aging ofthe population, and to the introduction in 2008 of a newpublic insurance scheme for long-term care.
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