[OUTLOOK]Health policies line the path to fiscal fitness

One of the main issues of the 2002 presidential election is health and welfare policies. The separation of medicine and pharmacies in 2000, a measure that forbids hospitals from selling medicine and pharmacies from prescribing drugs, caused the depletion of public health finances last year and brought acute confusion to the public and political parties. Physicians and pharmacists are still haggling over that policy.

Avid interest is being shown in the kinds of proposals the presidential candidates are offering on these policies. Active lobbying by interest groups is taking place to ensure that policies favorable to their own needs are chosen by the candidates.

The three major bones of contention in the health and welfare issue are the merger of the various types of public health insurance, the continuation of the medicine-pharmacy separation and the adoption of private health insurance policies. The candidates expressed differing opinions on two of the issues, excepting the adoption of private health insurance. No candidate, however, is sticking his neck out too far for any measure, cautious of the reaction from divided interest groups.

Whether to integrate the two separate funds of the public health insurance plan －－ one for employees with fixed incomes and the other for the self-employed, implemented on a regional basis －－ has been an issue of controversy for more than 20 years. The organizations in charge have already merged, but the integration of the funds has been delayed until June. The government's original plan had been to integrate the funds by January, but opposition from the majority Grand National Party has seen that plan delayed for a year and a half. That party's candidate, Lee Hoi-chang, had promised

"complete integration of the health insurance organization and finance" when he ran for president in 1997. This year he has changed his mind and now supports separate funds for the two health insurance plans. His reasoning is that the system would be unfair to employees with fixed incomes who would be paying their proper payments while the self-employed could get away with paying less by reporting smaller incomes. Mr. Lee, however, remains silent on whether the newly-merged National Health Insurance Corp. should be separated again into the two former organizations in charge of the separate funds.

Not surprisingly, the Millennium Democratic Party's candidate, Roh Moo-hyun, supported the integration plan that his party had proposed. Still, Mr. Roh has not given any solutions to the fundamental problems, such as a uniform health payment collection system, a prerequisite for the integration plan, or a plan to efficiently assess income, on which to base the payments.

Kwon Young-ghil, the presidential candidate of the Democratic Labor Party, wants integration and proposes that an agency to properly assess the incomes of the self-employed be set up. Mr. Kwon, unlike Mr. Lee, thinks the single payment collection system is something that can be solved after the integration of the funds.

Many voters still have trouble getting used to the medicine-pharmacy separation, a cumbersome plan they feel costs them more money and effort. A JoongAng Ilbo survey showed that nearly 80 percent of those who participated wanted the plan to be reviewed or revised.

Mr. Lee promises to form a committee to oversee the issue and come up with revisions. In the last election, he supported the separation as one of his campaign promises. After changing his position to preferring a "complete review" following the uproar in 2000 when the plan was initiated, he now supports a revision. Just what kind of revision he wants, Mr. Lee does not say.

Mr. Roh has argued, using statistics provided by the government for publicity uses, that the effects of the separation are gradually starting to show. He proposes that the main framework of the present policy be kept while minor adjustments, such as alternative methods to provide and buy prescription drugs, are explored. Mr. Kwon calls for a stronger implementation of separation. He said that inflated medical fees were the cause of the depletion of national health and welfare finances last year.

Both Mr. Lee and Mr. Roh feel that the present public health insurance system has its limitations and that a private system is needed along-side to supplement it. The two candidates offer different ways to set this up. Mr. Lee promises to bring in private insurance only in the areas not covered by the public health insurance system.

Mr. Roh wants to stabilize the public insurance system first and bring in the private insurance plans gradually only after increasing the benefits of the public health system.

A displeasing medicine plan

Voters have expressed strong discontent about the separation of medical and pharmacy practices that took place in 2000. Nearly 50 percent of those polled said they wanted the plan to be completely reviewed. An additional 30 percent wants a large-scale revision of the plan. That means nearly 8 out of 10 respondents want some kind of a major change to the present system.

Some 60 percent of the respondents who identified themselves as conservatives want the plan to be reviewed, surpassing the 40 percent who called themselves progressives.

Calls for a complete review were especially strong from those over 50, those with an education below the middle school level, housewives and those with the lowest level of income －－ below 1 million won ($833) a month. More than half of all these groups replied. A relatively low percentage of those demanding changes were people in their 20s, and they included college graduates, students and those from households with a monthly income of more than 5 million won.

By choosing to revise the plan, the Grand National Party's presidential candidate, Lee Hoi-chang, gains support of these voters on this policy. Among supporters of Mr. Lee, some 60 percent were those who wanted the plan to be reviewed and 26 percent felt revisions were needed.

By Lee Ha-kyung

hakyung@joongang.co.kr

by Special Reporting Team