The South Korean healthcare system has achieved rapid quantitative growth; however, it continues to face critical challenges in ensuring the fundamental right to health of its citizens. From the perspective of healthcare consumers and civil society, this article identifies structural problems such as imbalances in medical accessibility, instability in essential and emergency care, and the limited participation of consumers in healthcare policy-making. Although the constitution stipulates the state’s responsibility to protect public health, current healthcare policies often prioritize administrative efficiency and provider-centered interests over patient experiences and health outcomes. In particular, this article argues that these challenges are closely related to the inadequate functioning of an accountable healthcare management framework. Structural failures in essential care, workforce shortages, and regional disparities are insufficiently monitored and addressed at the system level, resulting in responsibilities being blurred or shifted to individual healthcare providers. Consequently, the risks and burdens arising from systemic weaknesses are ultimately borne by citizens. To address these issues, this article emphasizes two major shifts. First, meaningful consumer participation must be institutionalized within healthcare governance to strengthen accountability, transparency, and responsiveness. Second, family medicine and primary care should be reinforced as the cornerstone of a sustainable, community-based healthcare system that ensures continuity of care, prevention, and chronic disease management. Re-establishing the healthcare system based on the right to health is not merely a technical adjustment, but a structural transformation toward a responsible and accountable system in which the state clearly assumes responsibility for monitoring, learning, and corrective action.

Korea’s healthcare system is at a critical juncture as rapid population aging, rising chronic disease burdens, and fragmented care expose the limits of a hospital-centered, fee-for-service model. Although policy discussions have long emphasized strengthening primary care and introducing a “family doctor” system, past reforms have focused mainly on expanding services or redefining professional roles, without establishing clear accountability, care continuity, or aligned payment mechanisms. Consequently, primary care remains weak and responsibility for comprehensive patient management is diffuse. This article argues that meaningful reform requires redefining the primary physician as an accountable manager of longitudinal, coordinated care within an integrated delivery and payment framework. Drawing on experiences from the United States, the United Kingdom, and several European countries, it identifies common features of successful primary care–oriented systems, including patient registration, team-based care, risk-adjusted payment, and explicit outcome accountability. Based on these insights, the authors propose a Korean primary physician model tailored to solo and small-group practices while fostering regional collaboration. Core elements include voluntary patient registration, multidisciplinary primary care teams, risk-stratified care management, regional care networks, and a mixed payment model combining per-member-per-month payments, shared savings, and performance-based incentives. The article emphasizes phased pilot testing focused on operational feasibility. Ultimately, transitioning to a primary care–centered system is presented as a strategic necessity for sustainability and improved care continuity.

South Korea’s current healthcare system stands at a critical crossroads that will determine whether it can progress in a better direction over the next decade. Behind the relatively stable level of population health that has been maintained until now, it has become clear that the deterioration of patient experiences, the risk of collapse in critical emergency medical services, the burnout of healthcare providers, and the crisis in the sustainability of healthcare finances have all accumulated simultaneously. This crisis can no longer be overcome by partial fixes or short-term measures alone. The answer to what needs to change first must begin with a reaffirmation of what the healthcare system should aim for. Ultimately, what needs to be changed now is not an individual policy, but the criteria and priorities through which we view healthcare. The focus must shift from what to provide more of, to questioning what holds greater social value. If such a shift does not begin now, in ten years we won’t face a better healthcare system, but care enmeshed in a deeper crisis. Now is precisely the time to fundamentally define the direction of the healthcare system.

BACKGROUND: The value of endoscopy is more increasing as a tool of the cancer screening, and many studies are now progressed for decreasing the inconvenience of patients who undergo the endoscopy. There are some overseas studies that the video-education before procedures like colonoscopy or coronary angiography increases the satisfaction and decreases the anxiety of the patients. But in Korea, there is lack of studies about the methods of decreasing the anxiety of the patients before procedures especially endoscopy. METHODS: We carried out the survey with 95 patients underwent the endoscopy in the medical health checkup center of National Health Insurance Medical Center during 19 July 2008 to 8 September 2008. The patients who had the medical history of gastrectomy, had pains due to another diseases and had a prescription about psychiatric medicine including hypnotics were excluded. RESULTS: Statistically there are no differences between two groups of the video-education and the paper-education according to age, sex, height, weight, body mass index, numbers of former endoscopy, smoking history and educational standard. The video-education is more effective than the paper-education in decreasing the anxiety index between before and after the education. CONCLUSION: The prior video-education for the patients awaiting endoscopy can decrease the anxiety about procedure. Moreover, it can decrease the suffication of the patients and increase the satisfaction of physicians. If the patients feeling the prior anxiety are educated with the video before undergoing endoscopy, the video-education is very effective to decrease the prior anxiety of the patients.
Anxiety ; Body Weight ; Colonoscopy ; Coronary Angiography ; Early Detection of Cancer ; Endoscopy ; Gastrectomy ; Humans ; Hypnotics and Sedatives ; Korea ; National Health Programs ; Prescriptions ; Smoke ; Smoking