A survey on the appropriate level of premiums for National Health Insurance

Abstract

As the National Health Insurance Law was established in 2000, the finances of workplace health insurance and regional health insurance were integrated. However, since employee health insurance (workplace insurance) and self-employed health insurance (community insurance) still use different contribution rating systems, the problem of inequity of premiums has caused ongoing controversy. Therefore, to examine the public's satisfaction with premiums calculation methods, and collect opinions on solving the problem of inequity of premiums, this survey was performed. A computer-assisted telephone interview with multi-stage stratified sampling of the population in Korea was performed. Responses were obtained from 1,016 people aged 25 to 64 years. The analyses showed that, to the question about the premiums calculation methods, more respondents answered that they were unsatisfied (41.4%) than satisfied (36.6%). The responses differed depending on the type of health insurance. The proportion of those who were satisfied with their insurance was relatively higher among those with employee health insurance. On the other hand, among those with self-employed health insurance, the proportion of those who were dissatisfied with insurance was 3 times more common than satisfaction with it, showing that those who belong to the self-employed health insurance group are less satisfied with the premiums calculation methods. It was also found that the majority people perceive that the current single payer health insurance system should be divided into mutually separate employee and self-employed health insurance systems or a multiple payer health insurance system (60.3%). To achieve premium equity in the future, the Health Insurance Corporation should make a greater effort to determine income levels correctly. In the institutional improvement process of the premiums contribution rating system in the future, it seems necessary to carry out further research on a multiple payer insurance system reflecting the attitudes and demands of the people. © Korean Medical Association.