Publication:
Advancing Universal Health Coverage: What Developing Countries Can Learn from the Korean Experience?

Loading...
Thumbnail Image
Files in English
English PDF (1.61 MB)
1,071 downloads
English Text (115.79 KB)
56 downloads
Date
2018-01
ISSN
Published
2018-01
Editor(s)
Abstract
The Republic of Korea achieved universal health coverage in 1989, twelve years after the introduction of mandatory health insurance for employees in large corporations. Political legitimization of the authoritarian regime and rapid economic growth contributed to the rapid extension of health coverage. Most health care providers are private. In 2000, all insurance funds were merged into a single insurer, which improved the efficiency of risk pooling and equity in contribution payments. The single insurer system also provided the national health insurance system with the opportunity to strengthen its purchasing function. Nevertheless, the Korean health system faces challenges. Policy priority was given to population coverage, with low contributions and a limited benefits package, which resulted in insufficient financial protection of the insured. The rapid increase in private-sector providers has helped the supply readiness for universal health care, but has also engendered challenges to financial sustainability due to profit-seeking behavior and the overprovision of care, which was further exacerbated by fee-for-service payments. Korea’s health system also needs to be further reoriented to respond to the rapid aging of the population, and to the introduction in 2008 of a new public insurance scheme for long-term care.
Link to Data Set
Citation
Kwon, Soonman. 2018. Advancing Universal Health Coverage: What Developing Countries Can Learn from the Korean Experience?. Universal Health Coverage Studies Series;No. 33. © World Bank. http://hdl.handle.net/10986/29179 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Advancing Universal Health Coverage
    (World Bank, Washington, DC, 2018-01) Rosen, Bruce; Waitzberg, Ruth
    The Israeli health system provides universal coverage of a broad benefits package in a highly efficient manner. At the same time, the Israeli health system faces significant challenges, including lack of universal coverage for long-term care and adult dental care, center-periphery gaps, insufficient care integration, long waiting times for some elective procedures, and a growing private health care sector that poses several threats to the public system, cost containment, and health system equity. The Israeli health care system has benefited greatly from its capacity to identify relevant innovations in other countries and adapt them to Israel. At the same time, the Israeli experience can be a source of lessons for other countries. Aspects of the Israeli system that might be particularly relevant to middle-income countries include health plan competition in a clear and simple institutional environment, the reliance on health plans such as managed care and patient-centered organizations, the emphasis on primary care, and the investment in e-health. The manner in which Israel is grappling with its growing private sector can be a source of strategies middle-income countries could consider, and a source of strategies they should avoid.
  • Publication
    Advancing Universal Health Coverage
    (World Bank, Washington, DC, 2018-01) Smith, Peter C.
    The United Kingdom has in many respects the archetypal centrally planned, publicly financed health care system in the form of National Health Service (NHS), established in 1948 in a time of great austerity after Second World War. It is largely funded from general taxation, and provides wide coverage of most mainstream health services, with little recourse to user charges. It offers strong financial protection against the costs of health care and enjoys high public approval ratings. Its principal shortcomings have been weaknesses in service quality, often in the form of long waiting times, and sometimes relating to clinical quality. This paper concentrates on the experience in England, which accounts for 84 percent of the UK population of 64.6 million. The system of health service coverage adopted in the NHS is very simple. There is no explicit requirement to enroll in an insurance plan. Instead, citizens must register with a general practitioner (GP) of their choice. GPs act as a gatekeeper to nonemergency secondary care and prescription medicines and devices. Apart from small fees for some prescription medicines (from which many citizens are exempt), patients are not directly charged for access to NHS care. Throughout most of its history, the NHS model of governance has entailed strong central control by the national ministry, with local administration responsible for detailed local planning and purchasing. The forms of local administration have varied. In the early years of the NHS they were primarily local NHS hospitals, with separate committees for oversight of primary care. Since 1974, local health authorities have assumed the role of oversight of local services, currently covering, on average, populations of 250,000.
  • Publication
    Universal Health Coverage in Croatia
    (World Bank, Washington, DC, 2018-01) Vončina, Luka; Arur, Aneesa; Dorčić, Fedor; Pezelj-Duliba, Dubravka
    This chapter describes and seeks to take stock of a cluster of supply-side reforms that aimed to revitalize what was described by the Croatian Public Health Institute as a passive and low-impact primary care system. The cluster of reforms, which include a mix of organizational, primary care provider payment and pharmaceutical pricing and reimbursement reforms, and enabling information technology investments, were implemented starting in 2008. The chapter is organized as follows. Section two provides an overview of Croatia’s health system; section three provides an overview of Croatia’s Social Health Insurance System; section four discusses the financial sustainability challenges facing the Social Health Insurance System; section five presents the evolution and challenges of primary care in Croatia before 2008; section six discusses the primary care reforms implemented from 2008 onward and reviews the available evidence on its impact, including on how poorer regions and individuals may have benefited; and section seven concludes and outlines the way forward.
  • Publication
    Building Systems for Universal Health Coverage in South Korea
    (World Bank, Washington, DC, 2015-03) Na, Sanggon; Kwon, Soonman
    This paper broadly examines the development process of Korea’s health care system toward the achievement of Universal Health Coverage. Korea implemented a series of health care reforms after a rapid expansion of population coverage to improve efficiency and equity in financing and delivery of health care. The authors also investigate changes in the governance structure of Korea’s national health Insurance, which is now represented by two agencies: National Health Insurance Service (NHIS) and Health Insurance Review and Assessment Service (HIRA). Health insurance agencies have improved the accountability and transparency of the health insurance system, thanks to the ICT-based centralized claim review and assessment. Lessons and challenges from Korea’s experiences and achievements on the road to UHC could provide valuable policy implications to low- and middle-income countries.
  • Publication
    Universal Health Coverage in Low-Income Countries
    (World Bank, Washington, DC, 2018-01) Rosemberg, Nicolas; Wang, Huihui
    During the past decade, Tanzania has experienced steady economic growth, with average annual growth rates of between 6 and 7 percent. Despite this positive trend in the economy, poverty rates have not decreased accordingly; more than one-fourth of Tanzania’s 53 million inhabitants live below the poverty line and almost 10 percent live in extreme poverty. The health sector has been identified as a policy priority area in Tanzania. The main purpose of this case study is to describe Tanzania’s efforts to promote universal health coverage (UHC) inclusive of the poor, and to identify challenges and opportunities for the health system to advance on this path in a coherent and integrated fashion. Given the large number of interventions implemented in the health sector, efforts were selected based on their potential to address the challenges to the equitable access to health services, namely the poor quality of health services and the limited financial protection. The paper is organized as follows: section one gives introduction. Section two describes supply-side efforts and features the devolution of health services, the primary health care (PHC) strengthening program, and results-based financing. Section three analyzes Tanzania’s social protection program and synthesizes the country’s experience with user fees, as well as their impact on financial protection. Section four features the community health funds, Tanzania’s most explicit effort to increase financial protection in health. Section five assesses the implementation of these initiatives. Section six highlights some opportunities to include the poor and address the challenges to pro-poor UHC in Tanzania.

Users also downloaded

Showing related downloaded files

  • Publication
    World Development Report 2006
    (Washington, DC, 2005) World Bank
    This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Doing Business 2014 : Understanding Regulations for Small and Medium-Size Enterprises
    (Washington, DC: World Bank Group, 2013-10-28) World Bank; International Finance Corporation
    Eleventh in a series of annual reports comparing business regulation in 185 economies, Doing Business 2014 measures regulations affecting 11 areas of everyday business activity: Starting a business, Dealing with construction permits, Getting electricity, Registering property, Getting credit, Protecting investors, Paying taxes, Trading across borders, Enforcing contracts, Closing a business, Employing workers. The report updates all indicators as of June 1, 2013, ranks economies on their overall “ease of doing business”, and analyzes reforms to business regulation – identifying which economies are strengthening their business environment the most. The Doing Business reports illustrate how reforms in business regulations are being used to analyze economic outcomes for domestic entrepreneurs and for the wider economy. Doing Business is a flagship product by the World Bank and IFC that garners worldwide attention on regulatory barriers to entrepreneurship. More than 60 economies use the Doing Business indicators to shape reform agendas and monitor improvements on the ground. In addition, the Doing Business data has generated over 870 articles in peer-reviewed academic journals since its inception.
  • Publication
    Remarks to the Annual Meetings 2020 Development Committee
    (World Bank, Washington, DC, 2020-10-16) Malpass, David
    David Malpass, President of the World Bank Group, announced that the Board approved a fast track approach to emergency health support programs that now covers 111 countries. Most projects are well advanced, with average disbursement upward of 40 percent. The goal is to take broad, fast action early. The operational framework presented back in June has positioned the Bank to help countries address immediate health threats and social and economic impacts and maintain our focus on long-term development. The Bank is making good progress toward the 15-month target of 160 billion dollars in surge financing. Much of it is for the poorest countries and will take the form of grants or low-rate, long-maturity loans. IFC, through the Global Health Platform, will be providing financing to vaccine manufacturers to foster expanded production of COVID-19 vaccines in both part 1 and 2 countries, providing production is reserved for emerging markets. The Development Committee holds a unique place in the international architecture. It is the only global forum in which the Governments of developed countries and the Governments of developing countries, creditor countries and borrower countries, come together to discuss development and the ‘net transfer of resources to developing countries.’ The current International Financial Architecture system is skewed in favor of the rich and creditor countries. It is important that all voices are heard, so Malpass urged the Ministers of developing countries to use their voice and speak their minds today. Malpass urged consideration of how we can build a new approach to debt restructuring that allows for a fair relationship and balance between creditors and debtors. This will be critical in restoring growth in developing countries; and helping reverse the inequality.
  • Publication
    World Development Report 2011
    (World Bank, 2011) World Bank
    The 2011 World development report looks across disciplines and experiences drawn from around the world to offer some ideas and practical recommendations on how to move beyond conflict and fragility and secure development. The key messages are important for all countries-low, middle, and high income-as well as for regional and global institutions: first, institutional legitimacy is the key to stability. When state institutions do not adequately protect citizens, guard against corruption, or provide access to justice; when markets do not provide job opportunities; or when communities have lost social cohesion-the likelihood of violent conflict increases. Second, investing in citizen security, justice, and jobs is essential to reducing violence. But there are major structural gaps in our collective capabilities to support these areas. Third, confronting this challenge effectively means that institutions need to change. International agencies and partners from other countries must adapt procedures so they can respond with agility and speed, a longer-term perspective, and greater staying power. Fourth, need to adopt a layered approach. Some problems can be addressed at the country level, but others need to be addressed at a regional level, such as developing markets that integrate insecure areas and pooling resources for building capacity Fifth, in adopting these approaches, need to be aware that the global landscape is changing. Regional institutions and middle income countries are playing a larger role. This means should pay more attention to south-south and south-north exchanges, and to the recent transition experiences of middle income countries.