Experts have raised concerns that the 'Community Integrated Care' system, which was fully implemented nationwide in March, is struggling due to fragmented budgets and a lack of interest from local governments. As demand for care services increases and becomes more complex, overcoming the current limitations requires a comprehensive national action plan and a strong commitment from local leaders.
On September 22, a discussion titled 'Challenges and Strategies for Community Integrated Care Policy Development' was held at the National Assembly, co-hosted by Democratic Party lawmakers Nam In-soon, Seo Young-seok, and Kim Yoon. The event aimed to diagnose the limitations and regional disparities that have emerged since the nationwide implementation of integrated care and to explore effective medium- to long-term strategies.
During the session, Kim Yoon, a member of the National Assembly's Welfare Committee, identified the fragmentation of funding and governance as key issues that lead to service disruption. Yu Ae-jeong, head of the National Health Insurance Service's Integrated Care Policy Development Center, shared insights based on seven years of pilot program experience, highlighting the limitations and future challenges in the field.
Kim Yoon: 'Inefficiency Due to Fragmented Funding Requires Comprehensive Action Plan'
In her presentation, Kim Yoon characterized the fundamental contradiction in the current care system as 'fragmentation.' She stated, 'While the demand for complex care is rapidly increasing, services are being provided in a highly fragmented manner. This is due to the division of funding sources, including health insurance, long-term care insurance, and both national and local budgets, without a unified governance structure to coordinate them.'
She noted that funding for elderly care is heavily skewed towards facilities like nursing homes, resulting in a significant shortfall in budgets for 'home care services' that allow individuals to receive care where they live. To address these issues, Kim emphasized the urgent need for a comprehensive national action plan (roadmap). She proposed that the central government should provide clear standards and financial support, while local governments should have the authority to plan and implement services, holding them accountable for outcomes to reduce regional disparities.
Yu Ae-jeong: 'Local Leaders' Commitment is Essential for Care Network Reform'
Yu Ae-jeong pointed out that six months after the implementation of the program, numerous challenges continue to arise in the field. She argued, 'Integrated care requires a significant shift in the way health and welfare operate in South Korea. Without a strong commitment and a change in perception from local leaders, it is virtually impossible to foster inter-departmental collaboration at the municipal level.'
Yu highlighted the difficulties faced by local officials, citing issues such as a lack of organization and personnel, challenges in connecting with specialized agencies, and overlaps with other projects. She stressed the urgent need for a robust 'support framework' from the central government to address questions and resolve issues that arise during the early stages of the integrated care initiative.
She also warned about the current over-reliance on one-on-one home care services, which undermines sustainability. Yu suggested that priority should be given to restructuring services within the system, such as expanding short-term care and enhancing the system for severe cases in day care settings. Furthermore, she called for the development of new services tailored to the characteristics of care recipients, including addressing gaps in weekend and nighttime care and integrating dementia support centers as core resources for integrated care.
During the discussion, which was moderated by Nam In-soon, Vice Speaker of the National Assembly, participants included Seok Jae-eun, a professor at Hallym University, Kang Hye-kyu, director of the Central Social Service Center, Lee Hye-jin, a professor at Bundang Seoul National University Hospital, and Park Jae-man, an integrated care support officer from the Ministry of Health and Welfare, who engaged in intense discussions on rationalizing care funding and practical links between health and welfare.
* This article has been translated by AI.
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