KIHASA has released its January issue of the Health and Welfare Policy Forum, No. 327. (The articles are available for download here.)

SUMMARY OF THE FOREWORD: "The Role of the Korea Institute for Health and Social Affairs in 2024 and Far Beyond," Lee Tae Soo, President, KIHASA

The Korean welfare state has progressed in the wake of historically significant events. Following the 1997 Asian financial crisis, public health and social welfare, which until then had been given short shrift, came to the fore of attention. In view of the history of welfare states, it only stands to reason that a grave national crisis feeds into the momentum for advancing social welfare. However, Korea's welfare state has undergone unusual difficulties and delays in its development.

As a result of years of imperialist dictatorship and economic developmentalism, the ideology of 'growth over welfare' took root. While the Asian financial crisis highlighted the need for a welfare state, Korea's welfare system, lacking bold planning, remained for long trapped in incrementalism. Although welfare has emerged as an important issue through the debate on welfare universalism since 2010, challenges persist in the way of implementing welfare policies.

Four of these challenges stand out as particularly consequential to Korea's welfare state. First, the social welfare system lacks complementarity with the economic system. Second, the tax burden is low, adding difficulties to welfare financing. Third, there is the problem of inefficiency with social security programs and, thus, the need for reform of the social security delivery system. Fourth, there is a need for consensus-building around welfare politics and adequate preparedness for the ditigal transformation in the offing. It behooves KIHASA, a national research arm, to delve into these issues and provide mid- to long-term solutions. KIHASA should serve as the lodestar, a beacon on the path ahead for the Korean welfare state.

MONTHLY FOCUS: Health and Welfare Policy Directions for 2024

"The 2024 Outlook for Health Care Policy," Kang, Hee-Chung, KIHASA

In the year 2024, with Korea on the verge of becoming a super-aged society, concerns are growing over the financial strain resulting from the increase in the elderly population and the widening health disparities due to the economic crisis following COVID-19. Simultaneously, the aging population and the rise of chronic diseases will increase social demands for integrated management of health, medical care, and caregiving at the community level. As a key policy to protect the low-income population in the short term and enhance the sustainability of the future healthcare system in the long term, it is imperative to advance 'Innovation in Primary Healthcare at the Community Level.' In the healthcare policy landscape in these times of a growing aging population, innovation in primary healthcare is no longer a task that can be postponed. Reflecting national tasks and the outlook of the healthcare environment, the following specific tasks need to be pursued collaboratively: ① Development and pilot operation of a value-based payment model for primary healthcare targeting local residents, ② Systematic integration and expansion of financial support systems for medical expenses, ③ Restructuring the quality assessment framework for healthcare in the health insurance system, and ④ Proposing innovation promotion through digital transformation. These tasks, as they serve as the foundation for various other policy initiatives and all facilitate innovation in primary care, should be pursued with consideration of their mutual interdependence and scalability to the entire healthcare system.

"Prospects and Tasks for Income Security Policy," Kim, Taewan & Choi, Junyoung, KIHASA

In this article, we provide an overview of changes in the income security policy and matters discussed between 2023 and 2024, and examine what impact this will have on the income security policy in the future. First, between 2023 and 2024, reform of the income security policy was promoted focusing on specific groups. Second, those who are eligible to receive the income security policy will have stable income security, but the poor who are not eligible will continue to have an unstable income situation. Third, as individual systems are being improved in the form of individual breakthroughs, issues that need to be discussed in terms of consistency and equity between systems are arising. Fourth, as cash benefits in the form of allowances are operated mainly by metropolitan or basic local governments, Korea's income security system may become complex and difficult to organize.

"The 2024 Outlook for Social Service Policy," Ahn, Suran, KIHASA

Social service policies are aimed ultimately at people’s happiness and improved quality of life. As rapid societal changes unfold, the informal support system declines, and social risks expand and deepen, making the pursuit of a life worthy of human dignity increasingly challenging, there is a growing anticipation for relationship-based social services to take on a significant role. With the announcement in 2023 of its social services improvement directions and the 1st Basic Social Service Plan, the government has declared its resolve to materialize a close-knit, sustainable welfare state aimed at providing high-quality social services first to vulnerable groups, then gradually to whoever needs them. This article examines some of the announced plans, discusses how social service policies will play out in 2024, and makes policy suggestions for the improvement of social services.

"The 2024 Outlook for Social Security Expenditure Data Management," Shin, Jeongwoo, KIHASA

As Korea's social security expenditures grow at a markedly rapid pace, the need has arisen to consider how best they should be managed. For the effective implementation of social security projects, in particular, there is an acute need for the transparent management and timely provision of expenditure information. This would require a social security expenditure database that can be used not only for understanding the current state of the social security system but also as a means to monitor various social security policies, allowing for future projections and risk assessments. It is crucial to assess the performance of social security projects not merely in economic terms but, through metrics such as social return on investment, in terms of social values. In addition, I anticipate initiatives this year to develop a social security expenditure database and evaluate the appropriateness of social security expenditures in light of a deeper understanding of public perceptions regarding social security burden, all aimed at enhancing the sustainability and resilience of the social security system.

"The 2024 Outlook for Population Policy," Lee, So-Young; Hwang, Namhui; and Jang, In-Soo, KIHASA

Korea's demographic transition has been characterized by the unprecedented pace of the total fertility rate decline, population aging, and population decline. The government, in response, embarked in 2006 on the Basic Plan for Low Fertility and Aging Society, which is now in its fourth iteration. The government has recently announced new policy directions addressing the challenges of low fertility and aging population. Based on these directions, the 4th Basic Plan for Low Fertility and Aging Society is set to undergo revisions this year. The year 2024 is also important in that, with the 5th Plan coming up next year, there is so much to do to wrap up the policies implemented under the 4th Plan and assess their outcomes. Further policies should be established so that marriage, childbirth, and childrearing are choices for happiness. Additionally, a sustainable social foundation must be built that enables people of different generations to live in solidarity, coping well with living in a country where the population is increasingly aging.

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