In Korea, the proportion of medical costs due to chronic diseases among total health care expenditures is increasing rapidly. This trend calls for immediate countermeasures. In the major developed countries in Europe, a gatekeeper system has been adopted at the national level as a universal policy to manage and prevent chronic disease. In South Korea, insurers and local governments offer management programs to individuals with chronic disease and metabolic syndrome under the Korean government's Health Plan 2020, but these programs are fragmented and there are some related limitations. The role of the national government is very important to overcome this problem because the chronic disease management systems of other players (insurers, local governments) must be integrated. In addition, the expert patients program, which is intended to improve the self-care skills of chronic disease patients, needs to be better promoted. Incentives should include "mileage programs" in which patients can accumulate points for successful self-care. It is also important to increase public awareness through large-scale promotional campaigns. Finally, it is necessary to raise funds to conduct national-level campaigns and provide incentives to patients, and to ensure that all processes establish an organic cooperation system. Such practices will maximize the positive effects of a nationwide chronic disease management system in South Korea.