Structural Defects in the Lifecycle Management System for Severely Ill Patients and Plans to Strengthen National Responsibility: Focusing on the Establishment of Recovery Infrastructure and Reform of the Private Health Insurance System
10.21215/kjfp.2026.16.1.13
- Author:
Sung-ju KIM
1
Author Information
1. Korea Severe Disease Association, Seoul, Korea
- Publication Type:Review Article
- From:
Korean Journal of Family Practice
2026;16(1):13-16
- CountryRepublic of Korea
- Language:English
-
Abstract:
South Korea has entered an era of high survival rates for critical illnesses, with 280,000 new cancer cases annually and improved acute care outcomes.However, the current healthcare system remains heavily focused on acute treatment, lacking a comprehensive national management system for the subsequent stages of recovery, rehabilitation, and long-term survival. This structural defect results in a disconnected patient journey, characterized by confusion during diagnosis, repeated testing, absence of post-discharge care, and delayed hospice referrals. Furthermore, the financial toxicity experienced by severely ill patients is being exacerbated by recent reforms in the private health insurance system. Policies such as usage-linked premium hikes, the introduction of managed covered items with 95% copayments, and electronic claims data concentration pose significant risks to treatment access. To address these systemic failures, this article proposes two core strategies to strengthen national responsibility. First, the establishment of “Recovery Hospitals” (tentatively named) is essential. These institutions would serve as public infrastructure providing standardized navigator pathways, multidisciplinary care, and integrated information platforms across the patient lifecycle. Second, reform of the private health insurance system must prioritize patient protection over financial loss ratios. This includes banning discriminatory premium hikes for severe patients, mandating impact assessments for coverage reductions, and strengthening public governance over medical data. Ultimately, transitioning to a value-based, full-cycle management system is imperative to guarantee not only the survival but also the quality of life and economic security of severely ill patients.
