Korea Journal of Hospital Management (한국병원경영학회지)

Korean Society of Hospital Management (한국병원경영학회)
권호 표지

A Study on the Responses to the Change of Health and Medical Finance and Sustainability of the Influencing Foreigners

외국인 유입에 따른 보건의료재정 변화 및 지속가능성 제고를 위한 대응방안 연구

  • Jung, YongJu (Ministry of Health ＆ Welfare Gongju National Hospital)
  • 정용주 (보건복지부 국립공주병원)
  • Received : 2020.08.18
  • Accepted : 2020.11.13
  • Published : 2020.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.

Keywords

References

  1. Dustmann C, Frattini T. (2014). The fiscal effects of immigration to the UK. The economic journal, 2014;124(580):593-643.
  2. The UN Migration Agency (IOM) defines a migrant as any person who is moving or has moved across an international border or within a State away from his/her habitual place of residence, regardless of (1) the personʼs legal status; (2) whether the movement is voluntary or involuntary; (3) what the causes for the movement are; or (4) what the length of the stay is.
  3. Gott C, Johnston K. The Migrant Population in the UK: Fiscal Effects. London: Home Office. 2002.
  4. Stimpson J. Wilson F, Eschbach K. (2010). Trends in Health Care Spending for Immigrants in the United States. Health Affairs, 2010;29(3):544-550. https://doi.org/10.1377/hlthaff.2009.0400
  5. OECD Publishing. International Migration Outlook 2013. OECD Pub.
  6. Lee S, Chun C, Lee Y, Seo N. The National Health Insurance System as One Type of New Typology: the case of South Korea and Taiwan. Health policy, 2008;85(1):105-113. https://doi.org/10.1016/j.healthpol.2007.07.006
  7. Bohm K, Schmid A, Gotze R, Landwehr C, Rothgang H. Five Types of OECD Healthcare Systems: empiricalresults of a deductive classification. Health Policy, 2013;3(3): 258-269.
  8. Pitkin D, Bahney B, Lurie, N, Escarce J. Review: Immigrants and Health Care Access, Quality, and Cost. Medical Care Research and Review, 2009;66(4):355-408. https://doi.org/10.1177/1077558708330425
  9. Carrasco-Garrido, P. Jimenez-Garcia, R, Barrera V, Andres A. Miguel, A. Significant differences in the use of healthcare resources of native-born and foreign born in Spain. BMC Public Health, 2009;9(1): 201. https://doi.org/10.1186/1471-2458-9-201
  10. Wadsworth J. Mustn't grumble: immigration, health and health service use in the UK and Germany. Fiscal Studies, 2013;34(1):55-82. https://doi.org/10.1111/j.1475-5890.2013.00177.x
  11. Lokdam N, Kristiansen M, Handlos L, Norredam M. Use of healthcare services in the region of origin among patients with an immigrant background in Denmark: a qualitative study of the motives. BMC health services research, 2016;16(1):99. https://doi.org/10.1186/s12913-016-1346-1
  12. Igarashi Y, Horiuchi S, Porter S. Immigrantsʼ experiences of maternity care in Japan. Journal of community health, 2013;38(4):781-790. https://doi.org/10.1007/s10900-013-9679-8
  13. Mohanty S, Woolhandler S, Himmelstein D, Pati S, Carrasquillo O, Bor D. Health care expenditures of immigrants in the United States: a nationally representative analysis. American Journal of Public Health, 2005;95(8):1431-1438. https://doi.org/10.2105/AJPH.2004.044602
  14. Flavin L, Zallman L, McCormick D, Wesley Boyd J. Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review. International Journal of Health Services, 2018;48(4):601-621. https://doi.org/10.1177/0020731418791963
  15. Tarraf W, Miranda P, Gonzalez H. Medical expenditures among immigrant and non-immigrant groups in the US: findings from the Medical Expenditures Panel Survey (2000-2008). Medical care, 2012;50(3):233. https://doi.org/10.1097/MLR.0b013e318241e5c2
  16. Zallman L, Woolhandler S, Himmelstein D, Bor D, McCormick D. Immigrants contributed an estimated $115.2 billion more to the Medicare Trust Fund than they took out in 2002-09. Health Affairs, 2013;32(6):1153-1160. https://doi.org/10.1377/hlthaff.2012.1223
  17. McDonald J. Kennedy S. Insights into the 'healthy immigrant effect': health status and health service use of immigrants to Canada. Social science & medicine, 2004;59(8):1613-1627. https://doi.org/10.1016/j.socscimed.2004.02.004
  18. Kennedy S, Kidd M, McDonald J. Biddle N. The healthy immigrant effect: patterns and evidence from four countries. Journal of International Migration and Integration, 2015;16(2):317-332. https://doi.org/10.1007/s12134-014-0340-x
  19. Moullan Y, Jusot F. Why is the 'healthy immigrant effect' different between European countries?. The European Journal of Public Health, 2014;24(suppl_1):80-86. https://doi.org/10.1093/eurpub/cku112
  20. Derose K, Escarce J, Lurie N. Immigrants and health care: sources of vulnerability. Health affairs,2007;26(5):1258-1268.
  21. Magalhaes L, Carrasco C, Gastaldo D. Undocumented migrants in Canada: a scope literature review on health, access to services, and working conditions. Journal of immigrant and minority health, 2010;12(1): 132. https://doi.org/10.1007/s10903-009-9280-5
  22. McKeary M, Newbold B. Barriers to care: The challenges for Canadian refugees and their health care providers. Journal of Refugee Studies, 2010;23(4):523-545. https://doi.org/10.1093/jrs/feq038
  23. National Health Insurance Act. 2019
  24. OECD. (2016). OECD Health Statistics 2016. Available at http://dx.doi.org/10.1787/888933405637 [Accessed on 7 Jan 2020]
  25. NHIS, 2019 Health Insurance Major Statistics 2020.
  26. Lee B, Oh I, Lee E. Foreign Residents' Experience of Korean Health Care Services, The Journal of Korean Nursing Administration Academic Society, 2011;17(2):226-237.
  27. Kim S. The conception and factors that affect the utilization of health care services among foreign migrant workers in Korea, Multi-culture contents studies, 2015;18:255-297. https://doi.org/10.15400/mccs.2015.04.18.255
  28. IOM, Economic Impact of Migrants in Korea, 2010.