By Illan Nam
This publication offers an account of milestone medical health insurance reforms that happened in Korea and Thailand, which considerably complicated equitable entry and redistribution in future health care. Thai and Korean welfare champions have been deeply knowledgeable via their stories as activists of their international locations' democracy pursuits.
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Additional resources for Democratizing Health Care: Welfare State Building in Korea and Thailand
Reflecting systemic segmentation, the SSS and CSMBS had far lower enrollment of poor Thais. According to NHSO data (2004), the top two income quintiles accounted for 78 percent and 70 percent of the CSMBS and SSS members, respectively, whereas the lowest two quintiles accounted for only 11 percent of the CSMBS beneficiaries and 6 percent of the SSS beneficiaries (Prakongsai 2010). Universal Health Coverage: A Big Bang Transformation The National Health Security Act of 2002 (NHSA) that legislated the UC plan introduced several path-breaking changes to address these policy legacies.
57 million and below KRW280,000. 4 percent in 2006 (Chun et al. 2009). 22 The merger also helped avert the bankruptcy of societies that had been running fiscal deficits. By combining healthy societies with distressed ones, the single fund managed to maintain overall systemic solvency. 4 Source: Data from Korea Ministry of Health and Welfare (estimates) years, especially due to demographic pressures brought on by Korea’s rapidly aging population (Peabody et al. 2002). Unresolved Challenges Although the 2000 Reform introduced greater consistency and equity to assessing contributions, on balance, it ultimately had little effect upon mitigating the burden of high private health expenditures, which was principally fueled by steep OOP spending.
The burden of OOP spending fell more heavily upon lower-income groups. According to Ruger and Kim (2007, 807), in 1998, Koreans in the bottom income quintile spent KRW228,500 on OOP payments, which amounted to 13 percent of their income. This was almost the same amount that Koreans in the highest quintile spent, which represented only 2 percent of their total income. 23 This improvement, notwithstanding, Korea’s health financing continued to depend heavily upon OOP payments, which accounted for the high share of private financing to total health expenditures.