Our analysis of trends in the poverty rate and their influencing factors, conducted using data from the Survey of Household Finances and Living Conditions, revealed that the disposable-income poverty rate for disabled persons declined from 47.0 percent in 2012 to 43.0 percent in 2016. In the years 2016 through 2020, a period examined based on combined data―survey data supplemented with administrative records―the disposable-income poverty rate declined from 40.7 percent to 39.6 percent. Despite the continuous expansion of public transfers, disabled people did not see their disposable-income poverty rate fall all that much because of the increase in their market-income poverty rate. Our in-depth examination revealed that the rise in the market-income poverty rate among disabled people can be attributed to changes in their sociodemographic composition. These changes included aging, an increasing share of one-person households, and a declining proportion of disabled individuals cohabitating with non-disabled family members.
The cost of illness, a monetary estimate of costs arising from illness, serves as a useful indicator for assessing the socioeconomic value of health and for analyzing disparities in health outcomes between groups and across subnational regions. The cost of illness has been growing in Korea, with the proportion due to premature death from illness declining and the proportion due to living with illness growing. From a sociodemographic perspective, there is a need for health management policies targeting the population groups with increasing health care utilization, not least those age groups of either sex that remain a major active part of Korea’s socioeconomic landscape. Regional variations in the cost of illness have increased in recent years across cities, counties, and districts throughout the country. Policy interventions are required to address disparities in transportation expenditures, which this study finds vary more pronouncedly across regions than the other cost items. Moreover, caregiver costs also demand attention, as their regional variation has shown an increase in recent years.
Gender pension gaps in European countries, having been consistently kept in check as a core social policy indicator since the beginning of the 2000s, have increasingly narrowed in recent years. Korea’s National Pension is paying out an increasing amount of benefits to a growing number of recipients, but there still remain significant gaps between men and women in the number of years of contribution payments and the pension receipt rate. In Korea, women in many cases fail to secure an adequate level of pensions as, in addition to the fact that the pension rights they have are often of a derivative nature, such as survivor's pension entitlement, it is difficult in many ways for them to stay enrolled long-term―say, 20 years or longer―in the system. Reducing gender pension gaps requires proactive efforts to ensure more women have their own pension entitlements based on more years of contribution payments.
The latest financial projections of the National Pension and other occupational pension schemes have cast doubt on the sustainability of the public pension system. Public pensions are already beset by financial imbalances due to severe birth rate declines, population aging, and their payment structure where pensioners receive substantially more in benefits than they have paid in contributions. The civil servants’ pension and the military pension, their funds already depleted, have been running growing deficits despite the financial backing they have been receiving from the government. The National Pension and the private school teachers’ pension are on track to see their reserves depleted in 2055 and 2049, respectively.
The National Health Insurance and various social welfare programs implemented in the form of social assistance, having grown in expenditures as over time their target groups have expanded, face concerns over their financial sustainability. According to the Long-Term Financial Outlook for the National Health Insurance 2020~2060 of the Ministry of Economy and Finance, if its contribution rates remain capped at 8 percent and the level of government subsidy is maintained at the current level of 14 percent of the amount of anticipated contribution revenue, the National Health Insurance will see its surpluses accruing now turn in 2029 into deficits, which by 2060 will reach an estimated KRW5,765 trillion.
The basic pension is also a fiscal concern, as, amid the ongoing discussions about increasing its monthly benefit to KRW 400 thousand, it is expected that, with the rapid aging of the population, the number of its recipients will increase from 6 million in 2021 to 13 million in 2060. Against the background of rising social concerns regarding social security programs, including public pension schemes, and growing social demands for their improvement, this study revisits the current state of social security financial projections and explores options for improvement.
Customer service workers experience various mental health issues due to their emotional labor. Since 2018, a law known as the Customer Service Worker Protection Act has been in effect to safeguard these workers. However, policies that are in place for customer service workers, focused exclusively on post-facto interventions such as counseling, have done little to prompt efforts and participation from employers and, with the monitoring of compliance with the Customer Service Worker Protection Act lacking, have been rendered less than effective in promoting workers’ mental health. The guidelines of international organizations emphasize the need for workers’ mental health promotion, the importance of early intervention, and the role of employers in that effort. Advanced countries have in place a collaborative mechanism whereby, when it comes to policies on workplace mental health promotion, the government, labor unions, and employers work together in the whole process, from making to implementing them. They also mandate regular checkups on workers’ stress levels. Therefore, Korea should consider implementing regular mental health checkups, providing workplace visiting health services, strengthening the monitoring of compliance with the Customer Service Worker Protection Law, encouraging tripartite engagement, and facilitating employer participation and efforts.
Korea’s particulate matter policies remain in need of continued scrutiny, as particulate matter concentrations in Korea, while having trended downward recently, may well increase as the world progresses into recovery from covid-19. Our analysis of particulate matter data and death statistics for the city of Seoul found associations between short-term exposure to low-level particulate matter concentrations and the risk of death in certain sensitive groups. In the United States and Canada, national agencies such as the US Centers for Disease Control and Prevention the US Environmental Protection Agency, Health Canada, and Environment and Climate Change Canada have implemented policies on particulate matter and ambient air pollution and have provided action guidelines specifically tailored to sensitive and socially vulnerable groups in the event of high-level particulate matter concentrations. Assessments of the health hazards of particulate matter should be continuously updated, reflecting the latest findings. Monitoring of particulate matter concentrations needs to be strengthened, and such health services should be provided as to protect sensitive and socially vulnerable groups from exposure to high-level particulate matter concentrations. The system used for inspecting air quality in such public facilities as long-term care facilities and community elderly centers should undergo continuous examination for improvement.
It is true enough that of late the importance of local-level policy responses to low fertility has gained increasing recognition, but the issues tied to them have been left under-analyzed. This brief discusses the issues that arise from the current policy responses taken at the metropolitan municipal level to low fertility and draws implications for policy improvement. Our analysis of aggregate data on metropolitan municipalities suggests that there were differences in longitudinal changes between fertility variables. The number of national and public daycare centers, though having increased overall, has become more varied even across lower-tier localities in the same metropolitan municipality. Moreover, the childbirth support allowance programs as administered currently at the local level are likely to add to policy inefficiencies and fiscal burden with their potential for increasing inter-local competition for attracting population inflows. These issues call for producing data on the benefits received from the policy programs as they are administered at the metropolitan municipal level, improving the eligibility for support in public childcare as a way to increase the use of daycare centers, considering making use of the Fund in Response to Local Population Extinction, and allocating childbirth support funds on a sliding scale.
If an official disaster response is unaccompanied by policy measures to promote equity between social groups, the social inequalities that arise during the disaster may get worse after it is over. A survey of the perceptions of different social groups about disaster inequality found that people from lower social groups are more vulnerable to disasters and that the government’s disaster recovery support does not suffice for mitigating the vulnerabilities individuals have to disasters. The wide variation that emerged across different social groups in perceptions of disaster-borne inequalities may be attributed to how disasters can compound existing structural inequalities. This suggests the need for targeted assistance measures aimed at helping different social groups strengthen their resilience to disasters.
Electronic medical record (EMR) systems have been adopted by a large proportion of health care institutions in Korea. Due to differences in the way they function, however, these EMR systems have been less useful in sharing patient information between health care organizations.
An EMR refers to a digital record of patient information created and held by a specific health care organization. An electronic health record (EHR), by comparison, while also a digital version of patient information, is created by multiple health care organizations in a format that “conforms to nationally recognized interoperability standards.” The latest “Survey on the Current State of e-Healthcare” suggests that an estimated 93.3 percent of hospitals and higher-tier health care institutions (100 percent of tertiary general hospitals, 96 percent of general hospitals, and 90.5 percent of hospitals) have an EMR system in place, whereas EHRs are used only by 42.2 percent of hospitals and higher-tier health care organizations.
The Korean government in June 2020 instituted a certification program to ensure that EMR systems that health care institutions use to promote patient safety, care continuum and cost savings, are in line with national standards. EMR certification is about ensuring that a certain EMR system is in conformity with national standards and that health care institutions use a certified EMR system. What is significant about the EMR certification program is that it allows via data standardization a health care organization to share with ease with other health care organizations patient data that have been used within that organization alone, in an interoperable EHR format.
The EMR certification program should be further expanded, because it promotes the quality of health services and ensures continuum of care by facilitating innovation and increased efficiency in the health system. Also, data standardization, a process inherent to EMR certification, is a pivotal element in various government projects such as My Healthway Platform (a “health information highway”), patient information sharing, and the building of national data exchange infrastructure.
If EMR certification is to take firm root in Korea and promote the use of standardized patient information, more of small hospitals and clinics, which account for 99 percent of all health care institutions, need to participate in the certification program.