This year, only 33% of the 12 trillion won in legal government support was provided.
National health insurance budget turns into deficit in 2028… Health insurance premium bomb inevitable
It has been revealed that the statutory government subsidy that the government has not provided to the National Health Insurance Corporation this year exceeds 8 trillion won. There is criticism that the government is not fulfilling its obligation to provide government subsidies while pouring large-scale health insurance funds to resolve the legislative conflict and medical vacuum caused by the expansion of medical school seats.
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According to the National Health Insurance Corporation’s labor union on the 21st, it was confirmed that the government has granted a total of 4.05 trillion won in national health insurance subsidies five times this year.
Of the total 12.1658 trillion won in statutory subsidies for health insurance in 2024 that the government must initially pay to the Corporation, the amount paid as of November is only 33% of the total, bringing the unpaid amount to a whopping 8.1158 trillion won. The government plans to pay all outstanding amounts by the end of the year, but there are concerns that it will be difficult to pay the full amount of support due to the serious government budget deficit.
In accordance with the Health Insurance Act and the Health Promotion Act, the government has been required to provide support equivalent to 20% of the expected income from health insurance premiums for the year since 2007 to enable the Corporation to operate health insurance finances stably. 14% is raised from the general account (national treasury), and 6% is raised from the health promotion fund raised through cigarette taxes (tobacco charges). Accordingly, from 2007 to last year, 135.9567 trillion won, equivalent to 20% of health insurance premium income, had to be supported, but the actual support amount was only 115.8674 trillion won. The total amount of statutory support that has not been paid for 17 years exceeds 20 trillion won.
The National Health Insurance Corporation’s union said, “The government is not providing proper national treasury support this year, and next year’s budget plan does not provide national health insurance subsidy of 12.259 trillion won, which is 14% of the statutory support ratio, but 10.6211 trillion won, which is 12.1% of the government subsidy. “It was only organized,” he pointed out.
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Moreover, even now, if government subsidies are excluded from health insurance financial revenues, the deficit continues every year. According to the National Assembly Budget Office’s ‘2023-2032 Health Insurance Financial Outlook’ report published last year, the accumulated health insurance reserves will begin to be depleted starting in 2028, and the cumulative deficit is expected to reach 61.6 trillion won in 2032. .
If the government’s treasury support for health insurance decreases, the premiums paid by subscribers will eventually have to increase. However, the government froze the 2025 health insurance premium rate at 7.09%, the same as this year. The Ministry of Health and Welfare explained, “We decided to freeze for the second consecutive year for the first time, reflecting the national economic situation, such as continued high inflation and high interest rates, and the stable financial conditions of health insurance,” but the medical community has not been able to increase the health insurance premium rate for two years. The increase in 2026 is expected to increase further.
The bigger problem is that the government is using health insurance funds to resolve the medical crisis. The cumulative investment of health insurance finances from February to September, including advance payments for training hospitals that have difficulty operating emergency treatment systems and management, exceeded 2 trillion won, and the amount of investment is due to the ongoing structural transformation support project for tertiary general hospitals, etc. is expected to increase further.
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The National Assembly Budget Office recently released a report titled ‘Analysis of resource allocation by 12 sectors in the 2025 budget plan’, saying, “If excessive health insurance funds are invested to resolve the medical gap, the burden on the public may increase,” and the government is investing national finances instead of health insurance. proposed to review.
The report said, “When the government responds to the medical gap situation and promotes medical reform tasks, it is necessary to review ways to utilize national finances after going through the budget deliberation process of the National Assembly rather than excessively investing health insurance finances.” and “Responding to the medical gap.” He pointed out, “It is necessary to prepare measures to preserve the health insurance finances that have been invested or are scheduled to be invested in the promotion of medical reform at the level of the government and related organizations, and to prepare appropriate measures to control the increase in health insurance expenditures.”
Reporter Jo In-kyung [email protected]
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Guest 1: Dr. Lee Joo-won, Economist and Health Policy Expert
Section 1: Government’s Role in Providing Healthcare Funding
Interviewer: Can you provide us with an overview of the government’s role and responsibilities in providing healthcare funding through the National Health Insurance Corporation?
Dr. Lee: Yes, the Korean government is responsible for funding the National Health Insurance Corporation, which is the primary provider of healthcare insurance for citizens. The government is required to provide a statutory subsidy equivalent to 20% of the expected income from health insurance premiums, with 14% from the general account and 6% from the health promotion fund raised through cigarette taxes. This money is intended to stabilize health insurance finances and ensure that all citizens can receive necessary medical care.
Section 2: Government Failure to Fulfill Obligations
Interviewer: According to the article, the government has not provided 8 trillion won in statutory subsidies to the National Health Insurance Corporation this year, leading to a projected deficit. What are the potential consequences of the government not fulfilling its obligations towards healthcare funding?
Dr. Lee: The government’s failure to provide the statutory subsidy can have severe consequences for the National Health Insurance Corporation. It may result in an annual deficit, which could lead to depletion of health insurance reserves and eventual increase in health insurance premiums paid by citizens. Furthermore, if the deficit persists, it could negatively impact the quality of healthcare services provided and cause financial strain on individuals and families.
Section 3: Potential for Increased Healthcare Costs
Interviewer: How are excessive investments in healthcare reform projects using health insurance funds potentially related to an increase in healthcare costs for the public?
Dr. Lee: The government’s use of health insurance funds for non-healthcare-related projects could divert resources away from the Corporation, leading to a shortfall in healthcare funding. This shortfall may force the Corporation to increase health insurance premiums, thus passing the financial burden on to the public. Additionally, misuse of health insurance funds
