Financial risk protection of National Health Insurance in the

Objectives: Korea achieved universal population coverage through national health insurance in 1989. However, out-of-pocket payments (OOP) still accounted for 36% of total health expenditure in 2006. This paper aims to provide evidence for improving the benefit package through analyzing household financial burden. Methods: OOP and the incidence of catastrophic health expenditure were analysed using data from the Household Income and Expenditure Survey from 1995 to 2007. Results: The results show that OOP as a share of total household consumption expenditure were between 4% and 5% from 1995 to 2007. The incidence of catastrophic health expenditure has increased in recent years, from a low point of 1.6% in 2001, to 3% in 2007. The richest quintile had the highest incidence of catastrophic health expenditure, followed by the poorest quintile. However, the causes of the catastrophic expenditure are different among these groups: it is driven by inpatient and dental services among the richest quintile, whereas drug and outpatient services are main drivers for the poorest quintile. Conclusions: Our results suggest that the benefit package need to be rationalized by expanding coverage for inpatient care and particularly addressing special charges. On the other hand, entitlements to other types of benefits such as pharmaceuticals should be restricted.