July 30, 2021 (Southofseoul: 3 Major Differences Between Primary Care in South Korea and the U.S.)
There are several important differences between the primary healthcare systems in South Korea and the United States.
First, the definition and scope of primary care differ. In the U.S., primary care is primarily focused on the initial point of contact between patients and physicians, emphasizing health promotion, disease prevention, and improving access to care. In contrast, primary care in South Korea is hierarchical based on the type of medical institution, and some specialized services may be included in primary care in addition to family medicine and internal medicine. While referrals are not necessarily required for specialist services in the U.S., a gatekeeping system is in place, where referrals from primary or secondary care facilities are required to access tertiary hospitals in South Korea.
Second, the application of health insurance coverage varies. The U.S. lacks a universal healthcare system, resulting in disparities in access to care and higher out-of-pocket costs based on insurance type. In contrast, South Korea has a National Health Insurance Service (NHIS) that covers most citizens, with 50-80% of medical expenses covered. South Korea's relatively lower medical fees mean that the absolute financial burden is lower than in the U.S., and private insurance can be used to further expand coverage.
Third, there are differences in how copayments are calculated. In the U.S., copayments are fixed amounts designated by the insurance company, while in South Korea, they are determined as a percentage of the medical expenses. For inpatient care, the copayment is 20%, and for outpatient care, it ranges from 30-50% depending on the type of medical institution. However, due to the relatively low medical fees, the actual out-of-pocket costs are not excessively high. Additionally, there is a co-payment ceiling of around 3 million won (approximately $2,500) per six-month period.
Thus, South Korea offers universal and economical healthcare services based on the National Health Insurance and lower medical fees. However, it is helpful to verify NHIS enrollment and research the costs and services offered by individual medical institutions in advance. American residents in South Korea have reported positive experiences with the high accessibility and affordability of the healthcare system.
In the future, we plan to discuss the importance of cultural competency in healthcare access and strategies for overcoming language barriers. We hope this information has been useful in understanding and comparing the primary healthcare systems in South Korea and the United States. Thank you for reading.
3 Important Differences Between Primary Healthcare in South Korea and the U.S.