[Public Voices] Integrated Care: Taking the First Unwavering Step

Nam Hyunjoo, Dean of Graduate School of Social Policy at Gachon University

In Korea, which has entered a super-aged society, care is no longer an issue confined to a handful of families. The number of people staying for extended periods in nursing hospitals and facilities is increasing, and the burden on families has reached its limit. The desire to "live in one's own home for as long as possible" is only natural. Integrated care represents a policy shift that moves the focus of care from hospitals and institutions to the local community.

The national roadmap for community-based integrated care, set to be implemented nationwide in March 2026, is divided into three phases: introduction, stabilization, and advancement. In the first phase, the focus is on establishing the basic framework and delivery system, and on connecting existing health care, health management, long-term care, and daily living support services. The second phase aims to expand the target population and services, reduce regional disparities, and the third phase envisions a comprehensive care system that spans the entire cycle from frailty prevention to home-based end-of-life care.

However, although the Integrated Care Support Act covers not only the elderly but also people with disabilities and those with mental illness, the actual design of the first phase centers primarily on the elderly and some older adults with disabilities, causing significant concern. This is because, in practice, groups promised inclusion "from the second phase" or "from the third phase" have repeatedly experienced delays or exclusion. For true "integration," these voices must be genuinely heard.

At the same time, it is not a responsible approach to promise immediate inclusion of all groups while ignoring the current capacity of local governments. There are significant differences in care needs, healthcare and nursing infrastructure, as well as human and financial resources across regions. Some areas even lack sufficient visiting medical and care infrastructure. Universal declarations that overlook these realities only deepen mistrust on the ground.

Ultimately, the success or failure of the system rests with local governments. While the law and the roadmap are formulated by the central government, it is the responsibility of city, county, and district authorities to identify eligible individuals, coordinate services, develop personalized support plans, and mobilize local clinics, welfare institutions, and care facilities. Even in pilot projects, the gap between local governments with dedicated organizations and capabilities, and those without, has already become evident. If this is left unaddressed, integrated care will become just another welfare policy that, despite having the same name, results in entirely different experiences depending on the region.

Therefore, the role of the central government should not end with "leaving it to local governments." The current budget and personnel reinforcement are merely a starting point, and it is still inadequate for all 229 local governments to fully operate the system. Many of the newly added personnel are public staff responsible for administration and planning, making it increasingly difficult to secure people who actually provide care in the community. The central government must lay an institutional and financial foundation in the first phase by systematically training care managers, building partnerships with private and nonprofit service providers, and improving the working conditions of care workers.

In addition, there must be step-by-step mechanisms to ensure that integrated care for people with disabilities and those with mental illness is not postponed yet again. As the roadmap proposes expanding the target population to include people with high medical needs and those with severe mental illness in the second phase, and considers further expansion in the third phase, it is essential to clearly present from the outset the necessary legal and institutional improvements, budget allocations, and local government preparation plans. If expansion is delayed at the end of the introduction phase due to insufficient conditions, integrated care will lose trust from the very beginning.

Integrated care is not simply a bundle of separate projects, but a social commitment regarding how the state, local governments, and communities will share the burden of care. It is even more important that the roadmap continues to the next phase regardless of changes in administration. Now is the opportunity to transform Korea's care paradigm. While honestly acknowledging the preparedness and practical limitations of local governments, both the central and local governments must share responsibility so that all care recipients—including people with disabilities and those with mental illness—can be brought into the system as quickly as possible. That is the way to take the first unwavering step forward.

Nam Hyunjoo, Dean of Graduate School of Social Policy at Gachon University

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