Lee Yuri, Kim Siwoo, Kim So Yoon, Kim Ganglip
Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, Republic of Korea.
Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
Asian Bioeth Rev. 2019 Mar 29;11(1):41-56. doi: 10.1007/s41649-019-00079-1. eCollection 2019 Mar.
In the current era of the Sustainable Development Goals (SDGs), many countries are attempting to strengthen their health system and achieving Universal Health Coverage (UHC). The Korean National Health Insurance (NHI) system functions as a core element of health financing, contributing to achieving UHC by promoting public health and social security through insurance benefits for prevention, diagnosis, treatment, rehabilitation, childbirth, and health promotion. The Republic of Korea achieved 100% NHI coverage of the target population in 1989, 12 years after the introduction of the social insurance system. However, poor coverage of health services and lack of financial protection are major obstacles to achieving UHC. Therefore, the Korean government announced and implemented 'Moon Jae-in Care' in August 2017 to enhance the coverage rate of NHI by 70%. First, this study reviews the existing health insurance system in Korea from the perspective of health financing and UHC. Second, it analyses 'Moon Jae-in Care', based on the main framework of UHC. Third, it considers the ethical implications of these developments, with focus on the principles of equity, fairness, autonomy, and solidarity. Although the NHI reform is expected to propel Korean health care closer to UHC, many ethical, social, and political issues remain.
在当前可持续发展目标（SDGs）的时代，许多国家都在努力加强其卫生系统并实现全民健康覆盖（UHC）。韩国国民健康保险（NHI）系统是卫生筹资的核心要素，通过为预防、诊断、治疗、康复、分娩和健康促进提供保险福利，促进公共卫生和社会保障，从而有助于实现全民健康覆盖。大韩民国在引入社会保险制度12年后的1989年实现了国民健康保险对目标人群的100%覆盖。然而，卫生服务覆盖不足和缺乏经济保护是实现全民健康覆盖的主要障碍。因此，韩国政府于2017年8月宣布并实施了“文在寅关怀”计划，以将国民健康保险的覆盖率提高70%。首先，本研究从卫生筹资和全民健康覆盖的角度审视韩国现有的健康保险制度。其次，基于全民健康覆盖的主要框架分析“文在寅关怀”计划。第三，考虑这些发展的伦理影响，重点关注公平、公正、自主和团结的原则。尽管国民健康保险改革有望推动韩国医疗保健更接近全民健康覆盖，但许多伦理、社会和政治问题仍然存在。
