For the first time, the government will fold student health checkups into the national health screening system. Student screenings, which had been run separately by the Ministry of Education, will be transferred to the National Health Insurance Service so health information from infancy to old age can be managed under a single system. Starting next year, students will be able to receive screenings at medical institutions of their choice, and eligibility for blood tests will be expanded to include overweight students.
The Ministry of Health and Welfare on the 30th announced the fourth comprehensive national health screening plan reflecting these changes. Second Vice Minister Lee Hyeong-hoon said, "Student screenings have been conducted before, but consolidating the management system into the national health screening is meaningful in that it consolidates individual health data across the entire life cycle."
Beyond integrating student screenings, the plan includes an overhaul of the national health screening structure overall. The government will reassess and adjust screening items based on medical and scientific evidence, and it included a step-by-step plan to use artificial intelligence (AI) for risk prediction, image reading and follow-up management. For private health screenings, it plans to evaluate and disclose the validity of major test items to support public choice.
The following is a Q&A with Vice Minister Lee, Jeon Eun-jeong, Ministry of Health and Welfare's Health Promotion Division director, and Kim Sae-bom, Ministry of Education's Student Health Policy Division director.
-What will change when student health screenings are consolidated into the national health screening system?
"Starting in March next year, the National Health Insurance Service will be commissioned to operate student health screenings. Until now, students had to be screened only during set periods at institutions designated by the school principal, but going forward they will be able to choose a medical institution at any time of the year, like national health screenings. Student screening information will also be linked to the national health screening system, enabling integrated management of health information throughout the life cycle from infancy to old age."
-Will the target population or items change?
"The target grades remain the same: first and fourth grade in elementary school, first year of middle school, and first year of high school. However, blood tests will be expanded from obese students to include overweight students. The chest X-ray that all first-year middle and high school students currently receive will be changed so that only high-risk groups undergo additional tests after a questionnaire. The detection rate of diseases such as tuberculosis is below 0.1% and low, and the idea is to streamline this part and shift resources to support systems for obese and overweight students. We also plan to manage quality at screening institutions under standards similar to those for general screening facilities."
-Will the expense of student screenings shift to health insurance finances?
"No. While the National Health Insurance Service will handle operations, funding will continue to come from the grant-in-aid (earmarked tax). Only the management system will be consolidated into the national health screening."
-What about the expense associated with expanding eligibility for blood tests?
"We expect the total budget to increase by about 13 billion won."
-So will you raise the screening fees further?
"As hospitals begin testing overweight students as well, the budget will increase by the amount the expense rises. It is difficult to be specific because individual tests vary by student."
-There are concerns that low screening fees make it hard for medical institutions to participate.
"In the pilot program, we raised the fee application level from the previous 50% to 70%. Starting next year, weekend screenings will also be reflected."
-Will counseling content on student mental health or lifestyle habits be shared with schools?
"Not all content is provided to schools. Currently, information is linked mainly for high-risk groups who need support at the school level. Mental health is difficult to judge based on a questionnaire alone, so further review is needed."
-Will urine drug tests for students be introduced?
"They will not be introduced. The proportion of teenage drug offenders is very low, and it is not appropriate to view students as criminal targets. There are civil petitions demanding compulsory testing, but we considered privacy and human rights. Instead, we will strengthen education and counseling to prevent substance misuse, including smoking, drinking and drugs."
-If student personal information is transferred to the health insurance service, is there no concern about leaks?
"Because health information is consolidated across the life cycle, protecting personal information is very important. However, no separate measures were prepared specifically for this comprehensive plan. Legal grounds for linking student screening information are already in place, and we plan to link and manage the Ministry of Education's NEIS system with the health insurance service's system."
-How will the re-evaluation of national health screening items proceed?
"Priorities have not yet been set. However, a plan has already been decided to adjust adult chest X-rays from ages 20 and up to ages 50 and up starting next year. The remaining items will be re-evaluated sequentially under the principle of 'important health problems.'"
-If AI reading is introduced, who is responsible for misdiagnosis?
"It has not been decided yet. We are also considering using readings by radiology specialists together to reduce false positives and false negatives."
-How will private health screenings be managed?
"This is not about evaluating specific hospitals or products. We plan to assess and disclose the medical and scientific validity of individual test items that are common in comprehensive private health screenings. The idea is for the public and private sectors to build an evaluation system together to help people make informed choices."
-Will health screenings for special-type workers also be expanded?
"We are reviewing mandatory special health examinations for special-type workers such as delivery drivers who work at night. It is currently at the pilot stage, and the scope of application and timing will be decided in consultation with the Ministry of Employment and Labor (MOEL)."