Does universal health insurance reduce private financing for healthcare? Evidence from Korea.

Background: This study aims to empirically analyze whether the private sector’s financial resources can be expanded or crowded out by the expansion of national health insurance coverage. To this end, we examine the relationships between coverage enhancement, out-of-pocket expenses, and private medical insurance expenditure, using time series data. Methods: . To assess the impact of coverage expansion on the national health insurance system, we use the difference between the annual medical expenses of the national health insurance and those of the prior year as a proxy for the policy variable of strengthening coverage. Results: . The study finds that the coverage enhancement policy could increase national health insurance benefits, but strengthening public health insurance coverage may not affect private health insurance expenses. Conclusions: . This study provides new evidence about how expanding public finance in healthcare could simultaneously increase the private finance burden in developing countries where public health insurance has been designed without a sizable private health insurance market.