Health Policy Manag.  2023 Jun;33(2):166-172. 10.4332/KJHPA.2023.33.2.166.

Improvement for the Catastrophic Health Expenditure Support Program

• Seon JY
• Lim S
• Lee HJ
• Park EC

• KMID: 2549096
• DOI: http://doi.org/10.4332/KJHPA.2023.33.2.166

Abstract

Background
To improve the support low-income individuals’ medical expenses, it is necessary to think about ways to enhance the Catastrophic Health Expenditure Support Program. This study proposes expanding support criteria and changing the income standard.
Methods
This study conducted simulations using national data from the National Health Insurance Service. Simulations performed for people who have used health services (n=172,764) in 2022 to confirm the Catastrophic Health Expenditure Support Program’s size based on changes to the subject selection criteria.
Results
As a result of the simulation with expanded criteria, the expected budget was estimated to increase between Korean won (KRW) 13.2 (11.5%) and 138.6 billion (37.4%), and the number of recipients increased between 41,979 (48.9%) and 150,317 (76.1%). The results of the simulation for the change in income criteria (applied to health insurance levels below the 50th percentile) estimated the expected budget to increase between KRW -8.9 (-7.8%) and 55.6 billion (15.0%) and the number of recipients to increase between -8,704 (-10.1%) and 41,693 (21.1%) compared to the current standard.
Conclusion
The 2023 Catastrophic Health Expenditure Support Program’s criteria were expanded as per the 20th Presidential Office’s national agenda to alleviate the burden of medical expenses on the low-income class. In addition, The Catastrophic Health Expenditure Support Program needs to be integrated with other medical expense support policies in the mid- to long-term, and a foundation must be prepared to ensure the consistency of each system.

Keyword

Catastrophic Health Expenditure Support Program; Low-income class; Simulation; Out-of-pocket money