Health Policy Manag.  2021 Sep;31(3):364-373. 10.4332/KJHPA.2021.31.3.364.

Regressiveness Analysis of Contribution Rate of National Health Insurance Insured

• Na YK
• Moon Y

• KMID: 2525760
• DOI: http://doi.org/10.4332/KJHPA.2021.31.3.364

Abstract

Background
This study aims to examine the regressiveness of national health insurance (NHI) premium burdens for local subscribers. The government has established a restructuring of health insurance contributions in 2017. Therefore, insurance premium reform began in 2018 and the second national health insurance premium reform will be carried out in 2022. We will analyze local subscribers before and after the policy reform of 2018.
Methods
This study used data from ‘local premium imposition elements’ in the health insurance statistics annual reports (2017–2019) on National Health Insurance Service (NHIS). This study was calculated contribution rates according to levels of income and property for local insured by the method of comparing. Simulations of primary and secondary reforms were conducted in the study to determine regressiveness.
Results
Insurance premiums for local subscribers were analyzed separately by income and property insurance premiums. In the income premium analysis, the higher the income, the lower the premium rate, and then the fixed rate was maintained from a certain section. The regressiveness of income insurance premiums has been eased in part. On the other hand, the property insurance premium burden was found to be regressive still by income class.
Conclusion
Regressiveness analysis showed that a decrease in income contributions was achieved to local insured in the first phase of reform. But in the second phase of reform, more consideration should be given to reductions of property premium portions of local subscribers. Based on the results, the author suggested policy discussions to reorganizing the new systems of NHI contribution of local Insured.

Keyword

National health insurance; Contribution system; Local insured; Regressiveness