Medical insurance shift plans are advancing as North Korea prepares to overhaul its long-standing healthcare system. The move carries major significance because it would redefine how citizens access and pay for medical treatment nationwide. Officials appear determined to modernize funding structures while maintaining socialist language around public healthcare.
According to sources inside North Korea, planning intensified after the ruling Workers’ Party plenary session in December. Since then, the Cabinet’s Health Ministry and party departments have coordinated technical preparations across multiple agencies. They are now finalizing frameworks ahead of a formal announcement of the new healthcare model.
At the center of the proposal is mandatory enrollment in medical insurance for employees at state agencies and enterprises. Authorities are considering deducting premiums directly from monthly wages to ensure consistent participation. As a result, the financial burden of healthcare would shift more visibly toward individuals and families.
Officials are also discussing ways to extend coverage beyond formally employed workers. Under one option, working family members could pay additional premiums to cover parents or dependents. In addition, planners aim to include retirees who no longer work but still require regular medical care.
This reform represents a significant departure from the state’s traditional claim of universal free medical care. While the government has long promoted free treatment, patients already pay unofficial costs in practice. Therefore, officials now seek clearer institutional rules defining cost sharing for various treatments.
Under the proposed system, basic insurance would cover standard services at state-set prices. However, hospitalization and specialized procedures would require higher out-of-pocket payments. Consequently, households facing serious illness could experience increased financial pressure.
The medical insurance shift also aligns with recent investments in healthcare infrastructure. North Korea has built new hospitals and expanded so-called model pharmacies across provinces. Authorities reportedly concluded these facilities cannot operate sustainably under the current funding system.
Moreover, the reform connects to Kim Jong Un’s call for a public health revolution announced earlier this year. Leadership dissatisfaction with hospital efficiency has driven efforts to link healthcare, administration, and financial management more closely. Officials believe insurance mechanisms could stabilize operating costs.
As part of implementation planning, the Health Ministry is preparing social security medical insurance cards. These cards would integrate patient records across clinics and hospitals nationwide. Officials aim to improve oversight and track treatment more systematically through centralized data.
Despite momentum, uncertainties remain regarding premium levels and regional rollout timelines. Observers expect resistance from struggling households without stable incomes. Ultimately, the medical insurance shift could reshape healthcare access while introducing new economic challenges for North Koreans.
