Report

Institute for Future Strategy, Seoul National University — Healthcare Reform Task Force
“Strategies for Sustainable Future Healthcare Reform”

South Korea’s healthcare system has achieved a world-class level of infrastructure and technology within a short period, elevating its international standing. However, rapid changes in the healthcare environment and structural challenges have raised concerns about its sustainability. Population aging, the rise of chronic diseases, and soaring medical costs demand not fragmented responses but an integrated and systematic transformation of the healthcare system. The COVID-19 pandemic exposed fundamental weaknesses—gaps in essential healthcare, shortages of medical personnel, and regional healthcare crises—demonstrating that structural reform of the healthcare system is not a temporary option but an urgent necessity.

This study diagnoses key signs of crisis in Korea’s healthcare system, such as the collapse of essential healthcare, deepening regional disparities, and threats to financial sustainability, and establishes an integrated analytical framework across spatial, functional, and temporal dimensions to assess long-term sustainability. In the spatial dimension, healthcare access and individual health rights are closely linked with regional systems and the global health environment, requiring a multi-level perspective from the individual to the global. In the functional dimension, governance structures and service delivery systems must work organically and evolve harmoniously. In the temporal dimension, immediate challenges must be addressed alongside proactive preparation for future changes to ensure long-term sustainability.

Based on this multidimensional analysis, the study proposes the following policy directions for sustainable healthcare reform. In terms of governance, top-down government policy and unclear role-sharing among central, local, and private actors have created inefficiencies. A shift from an insurance-centered to a comprehensive healthcare policy is needed, supported by an independent policy research institute to provide expert and objective foundations for policymaking. In the regional dimension, the concentration of medical resources in the capital area has accelerated the hollowing out of local healthcare. Establishing a Regional Healthcare Special Autonomy Union is proposed to build decentralized, region-led governance, strengthen functional linkages among medical institutions, and foster self-sustaining regional healthcare.
In the service dimension, fragmented, treatment-centered care undermines continuity. Introducing a lifetime primary physician system can help integrate healthcare services. Rational reform of medical fee structures and the active adoption of digital healthcare and telemedicine are also necessary to improve quality and efficiency. In the individual and professional dimension, weakened trust and communication between doctors and patients reduce service quality. A shared decision-making model and stronger patient education, better working conditions for medical staff, and systematic training for professional development are essential.
At the global level, climate change and emerging infectious diseases pose major challenges. Proactive health adaptation measures for climate resilience and a transition toward a low-carbon healthcare system are needed. Building international cooperation networks for joint responses to global health crises has also become urgent.

In conclusion, the study emphasizes that achieving sustainable healthcare reform in Korea requires clearly distinguishing short-, medium-, and long-term priorities and establishing a structured implementation strategy. Continuous communication and coordination among stakeholders, supported by legal and institutional reforms, are essential. The establishment of an independent research institution dedicated to monitoring and evaluating reform outcomes will be vital for creating a dynamic and adaptive system capable of responding to future healthcare challenges.

Keywords:
Sustainable healthcare system, essential healthcare crisis, medical workforce shortage, regional healthcare disparity, healthcare governance, national health insurance, lifetime primary physician system, digital healthcare, telemedicine, low-carbon healthcare system, global health crisis, social consensus