Project

IFS

Directions for sustainable future healthcare reform

◦ Review of major discussion topics of the Healthcare Reform Task Force
Before discussing detailed topics, we would like to set a broad framework and develop major discussions within it.
In addition to the major issues discussed in the Healthcare Reform Task Force, we would like to review additional agenda items that take into account the changing environment of healthcare policy.

◦ Discussion on the roles of government and the market and their harmonization
The role of government: A review of the areas and roles that require government intervention, such as health insurance operation, regulation and management of medical institutions, and supply of medical resources.
Roemer (1993) argued that governments should play roles such as operating universal health coverage, covering essential healthcare, and managing healthcare organizations, and OECD (2021) emphasized the importance of the government's role in healthcare supply and regulation.
The role of the market: the functioning of the market in the provision of healthcare, medical technology innovation, consumer choice, etc.
Enthoven (1993) suggests that market competition can be introduced through managed care models to increase healthcare cost efficiency, while Cutler & Zeckhauser (2002) analyze that appropriate levels of market competition can promote healthcare quality and innovation.
Harmonizing government and the market: how to divide roles and cooperate between government and the market to achieve a balance of public good and efficiency.

◦ Discussion of the responsibilities and roles of hospitals, national hospitals, and the provision of quality health care, and definitions of quality health care
Discussion of the social responsibilities and roles of hospitals
Discussion of the interaction between the social role of hospitals and government policies

Discussion of public governance
Public governance in healthcare should be achieved through participation and collaboration with various stakeholders, including government, healthcare organizations, and civil society.
How to coordinate and resolve conflicts among stakeholders
Ensuring transparency and accountability in the policy-making process.
Systematic collection, management, and utilization of healthcare data.

Rebalancing the roles of the state and professional organizations, central and local governments, etc.
Developing measures to build a health care system based on trust and preventing inappropriate division of functions from undermining the effectiveness and efficiency of policies.
Strengthening the governance of health care by redefining the roles and responsibilities of governments, professional organizations, and central and local governments and establishing cooperation.

Strengthening primary healthcare to prepare for the transition to an ultra-elderly society
Strengthening primary health care has been shown to improve the quality and satisfaction of health care and positively impact individual health in terms of prevention and management (Shi et al., 2002; Macinko et al., 2003; Dinkler et al., 2016).
The promotion of primary health care has also been cited as a way to control health care spending, as it can control costs associated with unnecessary and expensive specialty care and resource use, which can lead to reduced health care utilization and lower health care spending (Sripa et al., 2019).
◦ Attention needs to be paid to reorganizing the healthcare delivery system to strengthen primary healthcare in response to accelerating aging to manage chronic diseases and promote health

Aging, ruralization, and regional spatial restructuring need to be considered together when discussing healthcare reform
Currently, the aging rate in Korea is very fast, and the healthcare needs of the elderly population are increasing significantly, so it is necessary to discuss this from the perspective of the consumer.
The demand for healthcare services for the elderly, such as chronic disease management and care services, is increasing, and it is necessary to reorganize the healthcare system to respond to this.
On the other hand, the population of small towns and rural areas tends to decrease due to low birth rates and the outflow of aging population.
Alternatives are needed to address the imbalance of medical resources between regions and increase local access to healthcare.
As a result, it is becoming difficult to respond effectively to the existing healthcare delivery systems, and a comprehensive approach is needed that considers the aging society, regional issues, and quality of life issues.

Based on the above discussion, we propose a healthcare reform system that considers the three pillars of climate change, ruralization, and aging on the horizontal axis, and governance (government, national universities, hospitals, social insurance, etc.), services (sustainability, quality, efficiency, etc.), and actors (providers, consumers, government) on the vertical axis.
Through this framework, we would like to discuss prioritization, 'desirable healthcare,' and 'sustainable healthcare' in Korea.
Both the reorganization of the healthcare delivery system from the provider side and the management from the patient's healthcare utilization side need to be considered.
We will review the materials studied to date, reorganize the discussions within this framework, and examine the current state of healthcare reform.
We will then suggest issues that need to be discussed and where future healthcare policy should be headed.