Can the basic pension be increased? Will hair loss treatments be covered by health insurance? Why is oversight of manual therapy being tightened, and how far has the discussion on a sugar levy come?
The Ministry of Health and Welfare disclosed the progress on welfare and medical issues closely tied to people's lives. Minister Jung Eun-kyeong, at a press briefing on June 11 marking the first anniversary of the Lee Jae-myung administration, outlined major policy directions including a basic pension overhaul, discussions on health insurance coverage for hair loss, a revamp of the emergency medical system, and improvements to the life-sustaining treatment system.
The following is a Q&A with Minister Jung Eun-kyeong, Deputy Minister for Planning and Coordination Kim Guk-il, Social Welfare Policy Director Jin Young-ju, Population and Social Services Policy Director Eun Sung-ho, Health Care Policy Director Jung Kyung-sil, and Medical Reform Task Force Head Son Young-rae.
-How will the eligibility and amount for the basic pension be adjusted?
We will finalize the direction of the overhaul in the second half of this year. The core is a shift to a "bottom-up" structure in which lower-income seniors receive more. This follows criticism that the current method of paying the same amount to the bottom 70% of seniors has limited effect in alleviating poverty. Some experts, however, note that sharply lowering the take-up rate would be inappropriate. We are also reviewing expert opinions that the current eligibility threshold—equivalent to 96% of the median income—should be converted to a median-income-based method. We will proceed step by step, considering the maturity of the National Pension.
-There is criticism that the plan to manage non-reimbursable manual therapy was pushed unilaterally.
The overall direction was aired at public hearings 2 to 3 years ago when medical reform implementation plans were being drawn up. The specific number of sessions and prices were decided after multiple discussions by a non-reimbursable care consultative body with participation from the medical community, patients, and consumer groups, based on criteria recognized under auto insurance and the actual distribution of non-reimbursable prices. We will maintain the current criteria, which recognize up to twice a week and 15 sessions in total for medical treatment purposes, with any excess at the patient's own expense, while continuously improving supplements during implementation.
-Some say covering hair loss under health insurance is populism. What is the timeline?
There are views that hair loss among young people has a significant impact on daily life, alongside the principle that coverage should focus on severe diseases. To build social consensus, the first topic of the "everyone's forum" on July 4 will address coverage for hair loss, with 200 members of the public participating. In a prior survey of 1,000 people by the National Health Insurance Service, many responded positively to coverage.
-What is the fundamental solution to stop "emergency room ping-pong"?
Emergency care is not a transport issue but a structural issue of final treatment in critical situations—namely, the capacity for emergency surgery. While capabilities for scheduled treatments like cancer surgery are excellent, the key is whether there is sufficient staffing to perform surgery at any time during 24/7 emergencies. As for what can be done immediately, the most important step is for 119, emergency medical institutions, and local governments to come together to create agreed-upon, region-level transport protocols. We must first link existing resources efficiently.
Structurally, by November we will revamp the designation criteria for emergency medical institutions from a facility-centered standard to one focused on final treatment capacity, and we will rename "regional emergency medical centers" as "severe emergency medical centers" to clarify roles. We will also implement a safety net next year that eases criminal liability for unavoidable medical accidents and expands government compensation support. The regional-essential-public medical office (Gipilgongsil) that will oversee implementation of related policies will launch in mid-July.
-Since the local elections, have there been discussions on introducing a sugar levy or raising cigarette prices?
A sugar levy can be reviewed in the context of a comprehensive obesity policy, considering WHO recommendations and childhood and adolescent obesity, but there are no concrete plans yet, and it remains at the stage of social discussion. As for cigarette prices, domestic prices are lower than the OECD level, and the 10-year health promotion plan includes a review of increases, but details have not yet been finalized. We will review this alongside smoking cessation policies tailored to the changing environment, including e-cigarettes and synthetic nicotine.
-A legislative vacuum on abortion has persisted for six to seven years. What is the solution?
This is a task that must be resolved. Relevant ministries, including the Ministry of Health and Welfare, the Ministery of Food and Drug Safety, the Ministry of Gender Equality and Family, and the Ministry of Justice, are currently coordinating key issues, and we are preparing an operational framework through amendments to the Mother and Child Health Act. We will finalize the government's direction in the second half of this year and promptly submit legal amendments to the National Assembly. We will consider both women's health rights and the protection of fetal life.
-There are suspicions that the National Pension is being mobilized as a defense tool during exchange-rate instability or to prop up stock prices.
This is merely part of our foreign exchange management policy to secure the fund's profitability and stability. We have also said that strategic ambiguity is necessary regarding the hedge ratio. The adjustment of the domestic stock share (setting a 20.8% benchmark) is not intended to boost stock prices; it reflects the reality that the gap between the actual holding ratio and the target ratio is too large to adjust abruptly. The existing policy stance of gradual reduction will be maintained while monitoring trends through next year.
-If the decision to withdraw life-sustaining treatment is expanded from "imminent death" to "terminal," there are concerns that vulnerable groups could be pushed for economic reasons.
Under the current system, the imminent-death stage is harder to determine than the terminal stage, which leads to unnecessary life-sustaining treatment. Because non-cancer diseases have high uncertainty in distinguishing terminal stages, we are also reviewing a phased approach as an option. To ensure no one is pressured to withdraw life-sustaining treatment for economic reasons, we will rigorously operate a structure in which ethics committees make medical and objective judgments.
-How far have discussions gone on alternative income security to prepare for AI-driven changes in employment structures?
AI-driven changes in employment structures may create an environment where the existing distribution system centered on social insurance may not function. We must build an alternative income security system suited to that. It is still difficult to propose specifics, but our current analysis is that income security support for young people is particularly lacking. It could take the form of basic income, and we can also conceive of various other models. We will gather opinions through the Future Social Security Forum at the end of June.
-What is the top priority, according to the Minister?
In the welfare realm, blind spots remain. The top priority is to move quickly on policies that protect vulnerable groups first and strengthen the safety net against welfare crises amid polarization. In the medical sector, our goal is to compile and announce, in the second half, plans by area for regional, essential, and public health care.