The Ministry of Health and Welfare on the 30th finalized the Fourth National Health Checkup Comprehensive Plan (2026-2030) after deliberation by the National Health Checkup Committee.
The core is to reorganize the expanded national health checkups, now about 2.6 trillion won a year, into an evidence-based system. Screening items that lack medical and scientific evidence will be regularly re-evaluated and removed, and student health checkups will be transferred to the National Health Insurance Service to link health data from infancy to old age. Artificial intelligence (AI) will be applied step by step throughout the screening process, from risk prediction to image reading and post-checkup health coaching.
At a pre-briefing, Kim Han-suk, Director General of health policy at the ministry, said, "Since the enactment of the Basic Health Checkup Act, health checkup finances have increased nearly fivefold in about 20 years," and added, "The core of this plan is to improve a structure in which, once included, it is hard for an item to be removed, and to create governance that allows items to come in and go out based on evidence, rather than being added according to civil petitions."
The key is execution. There is still no dedicated organization to continuously re-evaluate screening items, and neither the liability structure for AI readings nor the size of the fiscal outlay has been set. Observers say whether the plan to overhaul the national screening system will translate into actual policy depends on the design of follow-up measures.
◇Exit upon failing standards…restructuring of screening items begins
First, an "exit standard" will be introduced for national screening items.
Going forward, items must first meet the "significant health problem" standard. If they fail to meet any one of the following—prevalence of 5% or more, mortality of 10 or more per 100,000 people, or a disease burden (DALY) ranking between 1 and 35—no further feasibility review will be conducted.
Accordingly, the government decided to manage current screening items in four groups: ▲ essential items for the entire population ▲ tailored items for high-risk groups ▲ reserve items for new adoption ▲ items excluded for insufficient evidence and effectiveness. It also aims to raise the evaluation and adjustment rate for screening items from 10% in 2025 to 40% by 2030.
The evaluation system will also change. Evaluation of screening items, which had been outsourced to external research contractors, will be taken on by a dedicated organization within the National Health Insurance Service Research Institute. The government judged that relying only on external contracts makes it hard to run a continuous re-evaluation system.
The issue is the implementing body. Its size, operating method, and even launch timing are undecided. In response to a ChosunBiz question, Jeon Eun-jung, Director of the health promotion division at the ministry, said, "If the formation of a dedicated research organization is delayed, we may be able to re-evaluate only about one item a year."
◇Student screenings also to the service…a test for personal data management networks
Student health checkups will also come under the NHIS framework. Starting in Mar. 2027, students will be able to get screened at their preferred time and institution, like regular health checkups, rather than at an institution designated by the school principal.
What the government is aiming for is data integration more than student screenings. Once student screening information, which schools have managed separately until now, is transferred to the service, health information for infants, students, adults, and older adults can be linked within a single system. The ministry plans to build this into a "life-course health checkup comprehensive cohort" and use it for disease risk prediction and policy design.
The more data are concentrated in one place, the greater the management responsibility. That is why observers say safeguards must be put in place to protect it.
In recent years, the NHIS has repeatedly had cases of personal data protection violations. However, under the current Personal Information Protection Act, if fewer than 1,000 people's personal data are leaked, there is no obligation to report to the Personal Information Protection Commission or to notify externally, so many cases have been handled without becoming public.
◇AI introduced throughout the screening process…liability for misdiagnosis on hold
AI will be used throughout the national screening process.
Before screening, health information and medical use data will be analyzed to predict the risk of diseases such as lung cancer, and during screening an AI image-reading support system will be used. After screening, Generative AI-based health coaching and results explanation features will be applied to the "Health Insurance 25 Hours" app.
The government's vision goes a step further. Director General Kim Han-suk said, "We are also reviewing whether AI can read screening results for screening purposes without a radiologist," and added, "There will be major changes in the diagnostic field within the next five years."
Still, specific implementation plans have not been set. Neither the adoption timeline nor the investment scale has been decided, and no liability structure for misdiagnoses has been established. Director Jeon Eun-jung said, "We will consider adopting AI programs that have passed technology assessments," adding, "We will decide on application after accuracy has been sufficiently verified."
Debate continues over the reliability of medical AI. Earlier this year, a research team at the Icahn School of Medicine at Mount Sinai announced in the international journal The Lancet Digital Health that medical AI tends to accept unverified information as fact when it is packaged in medical terminology. A joint research team at the University of Oxford also reported in Nature Medicine that the accurate diagnosis rate of major large language models was only 34.5%.
◇Indirect regulation of private screenings…linking post-checkup management to fees dismissed
Post-checkup management will also be overhauled.
The government will raise the care linkage rate following general health checkups by 2030 to 34% for hypertension, 59% for diabetes, and 51% for dyslipidemia, and will reflect treatment linkage rates in the evaluation of screening institutions. In 2023, the respective linkage rates were 22.7% for hypertension, 39.1% for diabetes, and 34.0% for dyslipidemia.
However, the ministry drew a line at linking post-checkup counseling to National Health Insurance fees. Instead, it will create incentives for institutions that actively provide post-checkup counseling.
Disclosure of information on private health screenings will also expand. The medical and scientific validity of high-frequency screening items will be evaluated and disclosed, and sex- and age-specific recommendation guidelines will be prepared. While not direct regulation, disclosure of screening items the government deems to lack evidence is expected to have a significant impact on the market.
Director General Kim Han-suk said, "There is currently no system that can accurately grasp the state of private health screenings," and added, "We will create a system that provides evidence and information so people can make the right choices."