South Korea is grappling with gaps in its universal healthcare system, prompting discussions about a potential “second public insurance” option. While the National Health Insurance (NHI) covers a significant portion of the population, roughly 65% of healthcare costs, a substantial 35% remains the responsibility of individuals, often leading to high out-of-pocket expenses and reliance on private insurance. This imbalance is fueling a debate over how to ensure more comprehensive and equitable access to care.
The conversation gained momentum following an international seminar held on February 27, 2025, at the French Chamber of Commerce and Industry in Seoul. The seminar, titled “After Real Insurance, Seeking a Second Public Medical Guarantee System – Possibilities and Challenges of a Korean-style Medical Mutual Insurance,” focused on exploring a supplementary public insurance model, often referred to as a “mutual aid” system, to complement the existing NHI. The event was reported by I로운넷현장, a Korean news outlet.
The Current Landscape of Healthcare in South Korea
For over four decades, South Korea’s National Health Insurance has aimed to provide universal healthcare coverage. But, the system isn’t without its limitations. The 35% gap in coverage often necessitates the purchase of private “real insurance” (실손보험) policies to cover co-pays, non-covered services, and other expenses. This reliance on private insurance has led to concerns about over-medicalization, inequities in access, and distortions in both public and private insurance finances. The concept of a second public insurance aims to address these shortcomings by providing a more affordable and equitable safety net.
The proposed “mutual aid” system would function as a supplementary layer to the NHI, covering areas where the current system falls short, such as long-term care, rehabilitation, and home healthcare. This “dual public insurance system” would aim to create a more robust and comprehensive healthcare safety net for all citizens. The idea isn’t to replace the NHI, but to bolster it, creating a more resilient and inclusive system.
International Perspectives and the French Model
The February 27th seminar wasn’t an isolated event. It was part of a broader exchange of ideas regarding healthcare models. Just days before, on February 23, 2026, the French Chamber of Commerce and Industry in Seoul hosted a delegation from the French Mutual Aid Society (Mutualité Française) for a week-long seminar on Korean healthcare, insurance, and social security systems. The French Chamber of Commerce and Industry (FKCCI) highlighted the event, noting presentations from officials including Raphaël Lee, Counselor for Economic Affairs at the French Embassy in Korea, and Dr. O Chun-hee from the Korean Nurses Association.
Mutualité Française represents a network of non-profit health and social protection organizations in France. Their model, based on the principles of solidarity and mutual aid, offers a potential blueprint for a second public insurance system in South Korea. The French system emphasizes preventative care and community-based health services, which could be valuable lessons for South Korea as it explores ways to improve its healthcare system.
Key Discussions and Challenges
Discussions surrounding the implementation of a second public insurance system are complex. Key considerations include funding mechanisms, benefit packages, and administrative structures. Ensuring equitable access for all citizens, regardless of income or health status, is paramount. Careful consideration must be given to avoid duplication of benefits and to maintain financial sustainability.
Dr. Moon Hye-jeong of the Insurance Research Institute presented analysis on recent changes and trends in the Korean insurance system during the FKCCI seminar, offering insights into the current regulatory landscape. BioMérieux Korea also shared a case study, providing a perspective from the private sector. These presentations underscored the demand for a collaborative approach involving government, insurers, healthcare providers, and the public.
Next Steps and Ongoing Dialogue
The debate over a second public insurance system is expected to continue in the coming months. The discussions initiated at the February seminars are likely to inform policy decisions and shape the future of healthcare in South Korea. The FKCCI has indicated that the February 23-27 seminars aimed to deepen dialogue and strengthen strategic cooperation between South Korea and France in the healthcare sector. A blog post from the FKCCI details the events and their goals.
The next key checkpoint will be further analysis of the seminar findings and potential legislative proposals. Stakeholders are closely watching for official announcements regarding the government’s plans to address the 35% gap in healthcare coverage and explore the feasibility of a second public insurance system. The goal remains to create a healthcare system that is both accessible and sustainable for all South Koreans.
This is a developing story. Share your thoughts and experiences with healthcare access in the comments below.
