Eugene: North Koreans in the South Korean Healthcare system

Posted 07:06 PM, July 21, 2006, by esyim

From a conversation this morning with one of the vice presidents of the NGO, I gained some insight into the healthcare of North Koreans in South Korea.

Fortunately, South Korean policies regarding national healthcare extend to all people in the peninsula, including all North Koreans. North Koreans entering South Korea are thus eligible for coverage by the national health system.

Analogous to the Medicaid/Medicare system in the United States, the healthcare system in South Korea provides fiduciary support for the healthcare of the elderly and the poor. Virtually all the arriving North Koreans are thus eligible for this program, which covers the cost of most basic medical services and part of the cost of more advanced services.

The system works well for routine care but is often insufficient for more advanced needs. For example, the cost of an MRI in South Korea is about 500 US dollars. Since the MRI is considered an advanced service, the national health insurance program is only able to cover half the cost. This leaves about 250 US dollars to be paid out-of-pocket.

The South Korean government is generous enough to provide a 400 dollar/month allowance to support the North Korean migrants, but after elective use of advanced care, such an allowance is quickly depleted. As a result, many North Koreans opt out of advanced care even when it is medically necessary.

Having identified this issue, the NGO I am working for has begun efforts to address this concern. In May of 2006, the NGO opened up the Clinic for North Koreans, located at the National Medical Center in Seoul.

To learn more, I spoke with Dr. Jong Heung Kim, who is the chief of the department of surgery at the National Medical Center and is one of the medical directors of the free clinic. According to Dr. Kim, the clinic has two main goals:

1) to defray the cost of medical services not covered by the national health care system,
2) to help North Koreans navigate the South Korean healthcare system.

The North Korean clinic provides free medical consultation and basic medical treatment. In addition, the clinic provides more advanced services at a lower cost than outside hospitals. The medical center receives subsidies from the Ministry of Health and Welfare, and a portion of these funds are earmarked to support the care of the North Koreans. As a result, MRIs, X-rays, and endoscopic examinations are more affordable for the refugees and become a realistic option when the procedures are medically necessary.

The clinic is open every Tuesday afternoon and has already helped nearly one hundred patients since it opened a couple months ago. Patients schedule appointments at the clinic by calling into the NGO office. Dr. Lee, a former North Korean, takes an initial history over the phone and schedules the patients for appointments on the next clinic day.

Upon arriving to the clinic, the physician on duty meets briefly with the patient to record a more detailed history. The patients are then referred to appropriate specialists within the larger medical center for appropriate physical exams and treatment.

Although I came on an off-day at the clinic, there were three North Koreans who came in with urgent needs. Dr. Kim, who was technically off-duty, was happy to see the patients and address their needs. After seeing these patients, I reflected with Dr. Kim on the care of the North Koreans. I was concerned about how such a system would hold up as an increasing number of North Koreans enter South Korea.

Dr. Kim gracefully acknowledged my concerns and reminded me that the efforts of the NGO and the clinic are just a beginning.