Last Year Health Insurance Medical Expenses 86.5 Trillion Won... 11% Increase Compared to Previous Year

Status of Health Insurance Medical Expenses over the Past 7 Years

[Asia Economy Reporter Choi Dae-yeol] Last year, health insurance medical expenses increased by double digits compared to the previous year, surpassing 86 trillion won. The proportion of medical expenses for the elderly also increased.

According to the "2019 Health Insurance Major Statistics" released by the National Health Insurance Service on the 18th, last year's total health insurance medical expenses amounted to 86.4775 trillion won, an increase of 11.4% from the previous year. Health insurance medical expenses have steadily increased since recording 50.9541 trillion won in 2013, reaching 64.5768 trillion won in 2016. After surpassing 70 trillion won in 2018, it reached the 80 trillion won level within a year.

In terms of growth rate, it was slightly lower than last year's 11.7%, but the amount was higher. Medical expenses include the payments made by health insurance to medical institutions and the out-of-pocket payments made by patients to medical institutions, excluding non-covered medical expenses that are not subject to health insurance.

Medical expenses spent by the elderly aged 65 and over amounted to 35.8247 trillion won, accounting for 41.4% of the total medical expenses. Compared to 31.6527 trillion won (40.8%) in 2018, it increased by more than 13%. This is attributed to the increase in the elderly population due to aging. Considering that elderly medical expenses were about 18 trillion won in 2013, they have nearly doubled in six years.

The average monthly medical expense per person was 140,663 won, an increase of 10.9% from the previous year. The average monthly number of outpatient and inpatient days per person in the insured population last year was 1.77 days, an increase of 2.8% during the same period.

Benefits paid by the National Health Insurance Service increased by 11.2% from the previous year to 65.1674 trillion won. The burden increased as 1.6634 trillion won was spent on health checkups, which increased by 6.8% from the previous year due to expanded screenings for unemployed youth to eliminate blind spots in national health checkups and expanded lung cancer screenings for high-risk groups. Cash benefits amounted to 1.8978 trillion won, an increase of 24.2% from the previous year. This was due to increased refunds caused by institutional changes such as the application of positive airway pressure device benefits and differentiated upper limits by income level.

The population covered by health insurance, including insured subscribers and medical aid recipients, was 52.88 million, an increase of about 0.6% from the previous year. The workplace insured population exceeded 70%, totaling 37.23 million. In terms of medical expense share by type of medical institution, clinics increased by 0.5 percentage points, general hospitals by 0.3 percentage points, while hospitals decreased by 0.2 percentage points. Pharmacies also decreased by 0.7 percentage points.

The benefit costs of the so-called Big 5 tertiary general hospitals, including Seoul National University Hospital, amounted to 4.2341 trillion won, accounting for 8.1% of total medical institution expenses. Their share decreased by 0.4 percentage points from the previous year. Among tertiary general hospitals, the Big 5's share was 35.4%, similar to the previous year.

This content was produced with the assistance of AI translation services.