Page 142 - GHES-2-2

Global Health Econ Sustain

ORIGINAL RESEARCH ARTICLE
The effect of the 2009 cancer coverage

expansion policy in Korea

Changwoo Lee*
Department of Economics, Boston University, Boston, Massachusetts, United States of America

Abstract

This study focuses on the effect of coverage expansion policy on medical
expenditures at each initial medical expenditure level. More specifically, how each
structural change, such as the enforcement of coverage expansion policy and other
observable factors, influences the spending on medical care using the relatively
recently developed decomposition technique was investigated in the study. The
results showed that those at the lowest or highest medical cost level benefited
most from the policy change. The observable variables seemed to affect the overall
differences in the cancer inpatient cost for those at the middle medical cost level,
and the structural changes seemed to account for the overall change in the cancer
inpatient cost for those at the lowest or the highest medical cost level. The findings of
this study offer an explanation for why the coverage expansion policy could not affect
the equity in health utilization and financial burden reported in previous literature.

Keywords: Expansion of health insurance coverage; Medical expenditure; Decomposition
Academic editor:
Mihajlo Jakovljevic M.D. Ph.D. MAE
*Corresponding author:
Changwoo Lee 1. Introduction
(changwooda@gmail.com)
National health insurance coverage expansion is issued to improve public healthcare and
Citation: Lee, C. (2024). The
effect of the 2009 cancer coverage health performance. However, such a measure also raises some concerns. By lowering
expansion policy in Korea. Global out-of-pocket expenses, the policy could inadvertently increase health-care utilization
Health Econ Sustain, 2(2): 2001. and medical expenses. Many researchers attempt to investigate the overall effectiveness
https://doi.org/10.36922/ghes.2001 of the policy, but its effect on health promotion is challenging to quantify. Under the
Received: October 10, 2023 premise that medical service utilization directly affects health promotion, most studies
Accepted: February 19, 2024 only analyze the impact of the policy on equitable distribution of medical expenses and
health-care utilization by each income quantile (Kim et al., 2008; Choi, 2012; Kim et al.,
Published Online: June 4, 2024 2014; Kim & Kwon, 2014a, 2014b; Kim & Kwon, 2015).
Copyright: © 2024 Author(s).
This is an Open-Access article This study focuses on the effect of coverage expansion policy on the medical
distributed under the terms of the expenditure by each initial medical expenditure level. More specifically, how each
Creative Commons Attribution structural change (enforcement of coverage expansion policy) and other observable
License, permitting distribution,
and reproduction in any medium, factors influence the spending on medical care was investigated in this study. The findings
provided the original work is will illuminate whether such a change in policy alone aggravates health-care utilization,
properly cited. a reflection of whether the policy has effectively distributed the use of medical services
Publisher’s Note: AccScience throughout all levels of medical expenditure groups who are National Health Insurance
Publishing remains neutral with subscribers. This study attempts to quantify how the policy benefits those who receive
regard to jurisdictional claims in
published maps and institutional the medical coverage for the first time. The results revealed that subscribers with the most
affiliations. medical use received magnified, disproportionate coverage from the insurance since the

Volume 2 Issue 2 (2024) 1 https://doi.org/10.36922/ghes.2001