(EDITORIAL from Korea Herald on Aug. 12)

South Korea's national health insurance system is warning of potential financial difficulties ahead due to an aging population and underfunding. In the first quarter of this year, the system recorded a current account deficit of $2.8 billion, marking the end of five consecutive years of annual surpluses. The government had anticipated this deficit, but the speed at which it has worsened is concerning.

As the population ages, people aged 65 and older now account for 44.1% of medical spending, projected to increase to 53.1% by 2030 and 70.2% by 2050. At the same time, the group paying premiums through employment is shrinking, straining the system further. The core issue lies with the government's failure to meet its statutory funding obligations.

Under the National Health Insurance Act and the National Health Promotion Act, the government must provide an amount equivalent to 20% of estimated annual premium revenue, split between the general account (14%) and the National Health Promotion Fund (6%). However, over the past five years, the government has consistently fallen short, falling short by an estimated 22 trillion won.

The Lee Jae Myung administration acknowledged the problem but allocated support equivalent to only 14.2% of expected premium revenue, down from the previous year. This raises questions about the fairness of asking citizens to pay more while the state pays less than the law requires. The government's reliance on the health insurance fund for emergency measures and other expenses also blurs the line between social insurance and general taxation.

While higher premiums may eventually be necessary to address the growing healthcare costs, the government should prioritize enforcing the 20% obligation and seeking more sustainable sources of revenue, such as implementing stricter cost controls and exploring alternative revenue streams.