India turns to the South Korean model regarding Prime Minister Narendra Modi’s flagship universal healthcare programme, Ayushman Bharat. It is much in line with the government’s inclination to look at development models in East Asian countries rather than Europe or the US.

India has already borrowed important lessons from different countries for its 10-month-old Ayushman Bharat national health insurance scheme, but is now approaching closely at South Korea’s universal healthcare programme, which covers primary, secondary and tertiary healthcare.

Indu Bhushan, CEO at Ayushman Bharat, said that they have a proposal to study South Korea’s technological innovations in their universal healthcare programme and a team would be visiting soon.

South Korea is one of the earliest countries to safeguard universal healthcare through an Act of Parliament. It enacted Medical Insurance Act in 1963 and started contributive medical insurance programme for employees of large companies. By 1988, this scheme was extended to local medical insurance in rural areas. And in 1999, South Korea enacted National Health Insurance Act and within a year established National Health Insurance Service (NHIS) to bring in a single payer healthcare system.

Approximately 97% of the Korean population is covered by a contributory health insurance scheme and the rest 3% poorest of the poor segment is under government public health insurance scheme. The country is ranked first in healthcare access among high-income OECD countries.

NHIS under the health ministry supervises the contributory scheme, having different procedures for employees and self-employed insured. The employee’s contribution depends on his income and varies between $20 and $6,000 per month. For the self-employed, declared income, immoveable assets, age, property and vehicle ownership and gender are taken into account before deciding the monthly insurance contribution which varies between $11 and $3,000 per month.

NHIS and heads of six types of institutions – hospitals, clinics, oriental medicine, dental clinics, pharmaceuticals, and maternity hospitals – sit across the table in May to decide fee schedules of each healthcare facility and procedures every year and are declared in June. If negotiations fail, then a high-level committee under the health ministry declares them. These fee schedules are usually uniform and effective for only a year.

According to Inseok Yang, General manager of NHIS’ department of international relations and cooperation, one of the biggest successes of Korea’s universal healthcare programme, , has been the technological interface. It is a paperless system which has data of 50 million people collected over decades.

India launched Ayushman Bharat in 2018, which is termed as world’s largest health insurance scheme. One of the biggest lessons for India from South Korea is to go paperless and depend on IT interface to process claims and check frauds.

South Korea’s universal healthcare system faces a challenge in its gatekeeping system. Ayushman Bharat, is linked to Aadhar whereas South Korea’s system has no such checks.