Distinguished guests and colleagues;
Ladies and gentlemen:
Good morning and thank you for inviting me to speak on Universal Health Coverage.
UHC is a topic that has been at the centre of my career. For three decades, I was involved in the Korean national health insurance system — both as a witness and sometimes key player.
As you know, UHC is a global vision — that all people should have access to needed health services of sufficient quality to be effective without suffering financial hardship.
More and more, the world is realizing that healthier populations are a building block for sustainable development. UHC has even become an important target in the new Sustainable Development Goals.
But every country has a unique path to UHC, based on their particular social, political and economic context. The challenge is finding the right combination of policies, services and management measures to make UHC a reality.
For UHC to work, the health system must be able to protect and restore population health. This means that prevention and treatment must share the spotlight under UHC.
The WHO Regional Committee for the Western Pacific adopted a framework in October called UHC: Moving towards Better Health.
The framework offers countries a menu of actions, so they may select what best suits their priorities and needs as they develop a roadmap to UHC.
Of course, UHC is a lot more than financing. However, financing is key to health system development — and often triggers broader health system reform.
In this discussion, many cite the success of the Korean national health insurance system. Universal access for Koreans was achieved in 1989 — only 12 years after the decision was made to embrace UHC.
The Korean model can help other countries navigate towards UHC.
For example, countries should consider starting with low contribution rates and moderate benefit packages. Offerings can be increased over time with prudent financing.
To help control costs and make funding more sustainable, the Korean model emphasizes health promotion and prevention.
The model also points to the importance of maximizing cross-subsidies to build social solidarity. One plan for everyone means that no vulnerable groups are left behind.
Today countries can also take advantage of advanced management systems for health services that have been fine-tuned over decades.
These state-of-the-art systems greatly enhance quality control and cost effectiveness for countries moving towards UHC.
In broader structural terms, however, the Korean model may offer even more compelling guidance.
Under the Korean system, the functions of premium collection and registration were separated from those of purchasing.
National Health Insurance Services deals with population coverage and the collection of premiums. Meanwhile, the Health Insurance Review Agency works with providers to guarantee the price and quality of drugs and services.
This unique structure represents an effective division of labour. It also safeguards against an undesirable concentration of power.
Under Government supervision, these two national agencies work together with other stakeholders to chart the course of health system development.
This process allows a broader range of stakeholder views and expertise to shape major decisions — including contribution rates and benefits packages.
When I was president of the Health Insurance Review Agency during its early stages, we did not have a business model. So we relied on the best guidance of all — pragmatism and a pioneering spirit.
My time with the agency stands out as one of the proudest milestones of my career — because we created one of the first independent purchasing organizations in global public health.
We had the advantage of working during the computer age — which is even greater for countries moving towards UHC today. From the start, they can use big data to achieve levels of cost and quality control that were impossible decades ago.
As Regional Director, I see many countries with very different political, economic and social contexts.
Regardless of their level of development, however, countries share the challenge of establishing sustainable financing for UHC.
Forty years ago, the Republic of Korea faced many of the same difficulties developing nations today confront.
I remember the 1960s, when Korean per capita income was lower than that of Haiti and Ethiopia. Then 30 years of rapid growth pushed prosperity to a level that other industrialized nations took a hundred years to achieve.
This rapid development with great gains in health over a generation makes the Korean model especially relevant for developing countries today.
I hope that all participants make the most of this opportunity to share experiences and explore solutions to common challenges.
On behalf of WHO, I would like to thank the Korean Government for organizing this important event.
As a proud Korean, I am inspired by your efforts to improve health and assist other countries in the Region along the path to UHC.
Thank you.