(1) Different Health Insurance System perception survey timing
Korean population were surveyed between August to September 2019, and international students were surveyed between May to July 2022, resulting in a time lag of approximately three years between the two surveys. In conclusion, Korea’s health insurance is a system in which all citizens enroll in health insurance, pay for medical expenses, and receive insurance benefits. Citizens pay monthly health insurance contributions. However, several aspects should be considered to analyze the fairness of imposing health insurance contributions on international students.
The Korean health insurance system charges different contributions for different occupations, including workers, self-employed, and government officials. Contributions can be imposed in two ways: by charging a contribution proportional to an individual’s income or by determining an appropriate contribution and charging a portion of it based on the individual’s occupation. These ways take income levels and occupational characteristics into account and are generally considered to be fair. However, in the case of international students, it is difficult to accurately identify income from part-time jobs, etc., and when the work is done other than during legal working hours, it is difficult to verify income because wages could be paid in cash.
Contributions are imposed differently by economic status in South Korea. The system is structured for higher-income earners to pay higher contributions and for lower-income earners to pay lower contributions. By doing so, it aims to reduce the burden on economically vulnerable people and ensure that they pay their fair share. When determining contributions, ownership of a vehicle or a house is considered as well. However, when it comes to most international students studying in Korea from other countries, with the exception of Chinese students who have family support for their tuition, the differences in the economic power of the countries need to be taken into account. For example, the average income of a middle-class family in Uzbekistan should be set as a standard value, and it should be compared to that of major countries such as Mongolia and Vietnam. Contributions should vary based on an economic assessment of Korea.
Korean health insurance provides some coverage for medical services to those who pay contributions. This makes it more affordable for citizens to get the medical services they need. Benefits vary according to the types of medical services and are continually reviewed and improved in accordance with the National Health Insurance Act. Most international students are young and healthy, have a lower prevalence of chronic diseases, a lower awareness of using medical services, and a lower percentage of medical checkups. While they have a high demand for medical services related to dental care, emergency care, and the common cold, they are less likely to use medical services for treating chronic diseases, which affect heavily on health insurance finances. Thus, resistance to paying is highly likely if uniform contributions are imposed.
Therefore, the above factors should be considered to determine the fairness of charging for health insurance contributions.
It is also necessary to study other countries’ health insurance contributions for Korean population studying in foreign countries, such as the United States, Canada, Australia, etc., and prepare measures to promote the health of Korean population.
This was a general discussion of fairness, and further review and analysis in specific situations are required. Going forward, customized policies on health insurance contributions are needed to ensure that foreign students are able to integrate as members of the Korean community and that foreign talent can be attracted through visa-related policies.