코로나19의 보건의료 대응 정책: 건강보험정책을 중심으로

Abstract

In response to the coronavirus disease 2019 (COVID-19) pandemic, Korea has implemented various policies to manage the crisis in the healthcare system. In 2021, the Korean government used the National Health Insurance (NHI) funding to pay most of the COVID-19 related medical expenses (38 items). This study aimed to analyze the changes in the health insurance policy for COVID-19 health services and costs as well as to discuss the implications of such decisions. Healthcare policies with neighboring countries (Japan and Taiwan) that responded to COVID-19 were also compared. The total expenditure for the newly introduced fees for COVID-19 related services from January 2021 to November 2022 was KRW 8.14 trillion (January 2020 to February 2022, 46.1%; March to June 2022, 41.2%; July to November 2022, 12.7%). The total costs can be divided into five major service areas: patient treatment (43.0%), diagnostic tests (33.6%), vaccines and other (14.1%), non-COVID-19 care (5.6%), and prevention (3.7%). The service items of their proportions and total costs are as follows: mild patient treatment (residential treatment centers and home treatment, 22.3%), COVID-19 PCR (polymerase chain reaction) testing (20.7%), inpatient care (e.g., critically ill patients, 19.4%), and vaccination (10.9%). Due to the prolonged COVID-19 pandemic, medical insurance benefits should be adjusted flexibly by predicting their financial impact and expected effects. Moreover, the expansion of financial resources is required through various means of raising funds. Ultimately, a sustainable NHI system must be maintained. Similar to Korea, Japan and Taiwan expanded the medical benefits for COVID-19-related medical procedures and decided to release a supplementary budget for COVID-19 outbreaks in 2020.