Candidates treat health insurance as punching bag

YouTube ad of Decmoratic Party candidate Lee Jae-myung claiming that he ″plants″ hair. [JOONGANG ILBO]

Mr. Cho, a 46 year-old office worker, has been taking hair loss pills for the last five years. Even he wondered why Democratic Party presidential candidate Lee Jae-myung made a campaign pledge to have hair loss treatments covered by national health insurance.

“Hair loss treatment is purely cosmetic,” Cho said. “It would be better for the government to be focused on using the people’s taxes efficiently in areas that are in more need.”

Besides, Mr. Cho's Propecia generic pills only cost him 30,000 won a month.

“Hair loss is not an issue that really has a major impact on a person’s life,” Cho said.

In a neck-and-neck presidential race like the current one, no campaign promise is too small, and Lee and challenger Yoon Suk-yeol of the People Power Party have made a slew of micro promises, many targeted at people in their 20s and 30s who are still undecided.

Recent polls show that neither Lee nor Yoon has a strong upper hand.

“There always have been campaign pledges promising bigger benefits,” said Lee Jun-han, a professor of political science and international studies at Incheon National University. "These two candidates are called populists because they have failed to provide detailed or reasonable explanations for their policies."

The promise that made most headlines has been Lee's hair loss treatment pledge.

After news broke at the beginning of this year, the buzz on the internet was positive.

The candidate claimed that hair loss insurance coverage would not be a problem for the national health system.

“If insurance covers hair loss, [hair loss] drug prices will drop sharply,” Lee said on Jan. 9 while livestreaming on YouTube. “They say it would cost 70 to 80 billion won.”

The candidate insisted on the need of including hair loss in insurance coverage.

“They say those that people affected [by hair loss] amount to 10 million,” Lee said. “And family members are stressed as well.”

The medical community is worried that the reckless spending on such things as hair loss treatments will hurt the national health insurance system as a whole.


According to the Ministry of Health and Welfare, the national health insurance program, which was in surplus for seven years until 2017, recorded a deficit every year since after President Moon Jae-in's so-called "Moon-care" program took effect, the nickname derived from "Obama-care" in the U.S.

The government aggressively expanded insurance coverage to include MRIs and CTs, which encouraged patients without serious illness to get scans.

The goal of the policy was to lower medical costs for the general public and raise the insurance coverage rate to 70 percent of all medical bills.

In 2020, the coverage rate was 65.3 percent, up 2.6 percentage points from 2017 when Moon came into office.

The National Assembly Budget Office forecast that the system's deficit, which was 353 billion won ($294 million) in 2020, will reach 7.1 trillion won by 2025 in a report published last October. The NHIS reserve fund of 17 trillion won is projected to be depleted by 2024 as well.

Some argue that the national health system should focus on expanding its coverage of more serious illness — especially since it already covers hair loss resulting from diseases.

“Patients suffering from rare diseases and their families are devastated that insurance coverage for hair loss is being considered while so many critically ill patients do not even have access to medical services,” said the Korean Organization for Rare Disease in a statement on Jan. 13.

Lee raised the stakes later, saying that dental implants and eczema therapy should be covered as well.

“The national health system is already in the red, and society is aging rapidly ,” said Yang Jae-jin, a professor of public administration at Yonsei University, “which means that expenses are bound to increase over time.”

Yang pointed out that covering cosmetic procedures undermines the principle of the public health system, since the primary purpose is to support people suffering from diseases.

“If insurance is to be extended, diseases with higher priorities should come first, or public health insurance will no longer be sustainable,” said Yang.

The PPP’s Yoon kicked up his own controversy over health insurance unrelated to Lee’s.

Yoon accused some foreigners of taking advantage of Korea’s public health insurance.

The PPP nominee pledged to curb the abuse of public health insurance by foreign residents and their dependents, especially Chinese.

“Eight out of 10 foreigners covered by the national health insurance service were Chinese, and six of them were registered as dependents.” Yoon wrote on Facebook on Jan. 30.

He was considered to be tapping into anti-Chinese sentiment, especially as the Moon government has been seen more pro-China than past governments.

Yoon pointed out that dependents are not required to be long-term residents in Korea to be covered by national health insurance, which makes the system vulnerable to fraud and abuse.

Yoon claimed that in one case, a Chinese dependent with a rare disease only paid 10 percent of total medical costs from his or her's own pocket, while 3.3 billion won was covered by the Korean health insurance.

According to a claim by lawmaker Lee Yong-ho last September, a Chinese with hemophilia was given medical treatment between 2017 and July 2021. While the bill was 3.3 billion won, the patient only paid 332 million won.

Yoon emphasized that the NHIS was established and funded based on "Koreans' hard work over the last four decades."

Other unusual pledges by Yoon include a special zone for fishing fanatics, an attempt to appeal to people who fish as a hobby.

BY LEE HO-JEONG, SHIN HA-NEE [lee.hojeong@joongang.co.kr]