Forty two years ago this autumn, a new Peace Corps volunteer fresh out of college, I headed for South Korea to work as a Tuberculosis control technician. Over the next two years, I traveled throughout the villages of rural southwestern Korea with my Korean co-workers, identifying people with TB symptoms for treatment, dispensing information about the disease, collecting sputum samples, and performing countless tests in the health center’s spartan lab.
In those days, Korea’s rural healthcare system was rudimentary, though the country had begun its rise to the vigorous, prosperous, free and democratic society it is today. Along the way, Korea created a system of universal single-payer healthcare that ranks among the world’s most modern and effective. The Korean healthcare system’s quick response to the COVID-19 pandemic not only saved thousands of lives, but proved the model for the rest of the world to follow. Though Korea’s population is 14 times larger than Connecticut’s, it has suffered less than a quarter of the deaths of our state.
Clearly an effective healthcare system alone is not enough to block the COVID-19 pandemic, as the struggles of European countries demonstrate. Effective leadership from the top is also key. Korean President Moon Jae-In demonstrated it in spades, while new details of Donald Trump’s criminally incompetent response are being revealed seemingly by the day. But when America ascends out of this viral nightmare, we should carefully examine South Korea’s healthcare system as a model to replace our grossly overpriced and ineffective system.
South Korea provides national health insurance to all citizens though the National Health Insurance Corporation under the Korean Ministry of Health and Wellness. It’s financed by an average 5.06% payroll deduction out of monthly income, split between employer and employee. The self-employed are assessed health taxes based on income and assets, while low-income families are exempted from monthly payments. There are out-of-pocket payments, but they’re capped at a low level. Koreans are free to choose their doctors and hospitals. Most of the country’s doctors are in private practice, most hospitals privately owned.
How effective is Korea’s single-payer system? While covering every citizen, healthcare spending totals less than 8% of GDP, compared with over 18% for America. Korea pays less than a third per capita for healthcare as does the United States- $3,000 versus $10,000 in the U.S. With pharmaceutical prices controlled by the government, drug costs per capita total less than half America’s $1,000. Korea entered the COVID-19 pandemic with nearly four times the hospital beds per population as the United States, permitting easy accommodation of its coronavirus patients. By contrast, America has closed more than 120 hospitals over the past decade, while states and municipalities cut 55,000 jobs in public health. Korean medical schools produce nearly as many doctors per population as the U.S., while the country employees half again as many nurses.
Yet while spending a fraction per capita and less than half as much relative to GDP as we do, Korea’s health outcomes are excellent. According to OECD statistics, Korea’s infant mortality rate is less than half that of the United States, while maternal mortality is barely half America’s, and dropping. Korea’s avoidable mortality rate, meaning deaths that can be mainly avoided through effective public health and primary prevention, or through timely and effective health care interventions, is half America’s. Further, Korean life expectancy, at 82, ranks among the highest in the world, four years longer than America’s. And while Korean life expectancy continues to rise, America’s is declining. While America’s elderly face ruinous costs for long-term nursing care, Korea’s single-payer system is implementing affordable long-term care for its aged.
America’s corporate media continue to propagate the falsehood that single-payer universal healthcare is “pie-in-the-sky,” impossible to implement, exorbitantly expensive, eliminating patient choice. In fact, a recent study by Yale School of Public Health’s Center for Infectious Disease Modeling and Analysis concluded that implementing single-payer universal healthcare would save America more than US$450 billion annually, and prevent more than 6,000 deaths each year.
That is what senators Bernie Sanders and Elizabeth Warren “get” that the GOP and corporate media refuse to understand. South Korea’s system of single-payer universal healthcare has demonstrated how such a system can save lives during a pandemic, and during normal times as well. It’s time that America woke from the haze of disinformation to recognize that our current healthcare system is utterly broken, and that now’s the time to implement single-payer universal healthcare.
In a generation Korea created one of the world’s best healthcare systems. It’s time for America to follow suit.
Sean Goldrick is a retired investment professional who served as a Democratic member of the Greenwich Board of Estimate and Taxation, the town’s finance board.