[Editorial] Curbing health care costs

The National Health Insurance program has a loophole that helps rich people pay a far smaller proportion of their income in premiums than most people. Under the present system, the subscribers are divided into two categories ― the employee insured and the self-employed insured.

For employee-insured, the contribution is based solely on salary, with income from other sources not taken into account. In contrast, for the self-employed insured, contributions are calculated on the basis on their estimated overall income.

The use of these two different calculation methods creates an incentive for rich self-employed people to disguise as employees by putting themselves on the payroll of a company on which they have influence. Then they can have their NHI premiums computed on the basis of their puny salaries rather than their large actual income from various sources.

The Ministry of Health and Welfare has decided to plug this loophole by collecting additional premiums from salaried workers on their non-salary income, which includes private pension payments, housing rent and interest earnings. The contribution rate on non-salary income will be 2.82 percent, the same as that levied on salary. The ministry said it would submit a bill on NHI reform to the National Assembly this year. If approved, it will go into effect in the second half of next year.

The ministry’s move is welcome as it will help make the NHI program more sustainable. The nation’s health care costs have risen steeply in recent years, raising questions about the viability of the health insurance scheme. To ensure its sustainability, the ministry needs to double down on its campaign to rein in health care costs.

In this respect, the ministry made a move in the right direction last week when it decided to cut the prices of some 9,000 drugs by 17 percent on average next year. Domestic pharmaceutical companies are still protesting the decision, saying it would strangle them to death. But the measure, if implemented as planned, will help curb health care costs.

While bringing health care costs under control is important, the government needs to make the NHI program more accessible for people who really need it but are denied access because they cannot pay premiums. To address this problem, a reform committee on health care proposed the establishment of a fund to provide interest-free loans for needy people to cover their medical bills. The plan deserves a try.