Korea plans to take blood pressure and diabetes care from 19 areas to the whole country and all ages
Small payments that helped older patients with clinic and drug costs will become points earned through walking and other healthy habits. Some doctors worry patients will drop out of treatment.
01What happened
On November 5, the Korea Disease Control and Prevention Agency announced detailed plans to expand its blood pressure and diabetes program nationwide. It turned the direction it set out on September 30 into a timeline.
There are three main changes. Registration and education centers for high blood pressure and diabetes, now in only 19 areas, will become chronic disease management centers and spread to more areas. The program will cover all ages, not just people 30 and over. And the small payments older patients got for clinic and drug costs will be replaced by a points system called the Healthy Living Support Fund.
02How the program works now
The program started in one area in 2007 and grew to 19 cities, counties and districts by 2012. No new area has joined in the 14 years since. That is 8.4% of Korea's 226 local governments.
Registered patients get education and counseling at the centers, plus reminders so they do not miss check-ups. Patients 65 and over got help with clinic and drug costs of up to 42,000 to 66,000 won a year. The 66,000 won maximum applied to people with both conditions.
The agency points to fairness. Of 6.09 million people 65 and over with high blood pressure, only about 400,000, or 6.6%, are registered in the program. The help you could get depended on where you lived. As the population aged, the payment budget was also running out early each year.
03What changes
The program will cover all ages, not just people 30 and over. Beyond blood pressure and diabetes, it will gradually add other chronic conditions such as abnormal cholesterol.
New areas will be chosen through applications in the first half of 2027. Their centers will open in July 2027 and offer education, counseling and reminders to people of any age.
The existing 19 centers will use 2027 to prepare. They keep their names and their education, counseling and reminder services during that year. After a review at the end of the year, they become chronic disease management centers from 2028.
04How the money changes
The clinic and drug payments will end. Support moves instead to the Healthy Living Support Fund, part of the Health Ministry's primary care program for chronic disease, and is paid from national health insurance funds.
The fund gives points for healthy activities such as walking, education and counseling, worth up to 80,000 won a year. On paper, that is more than the old maximum of about 66,000 won. After complaints that the process was too complicated for older people, the Health Ministry changed it last December so patients can use their points to pay at participating clinics without a card.
But patients must meet conditions to earn the points. The old payment came automatically with each visit; the new one requires signing up and doing the activities.
05Opposition
The existing centers are pushing back. They argue the change could break down a local system that has kept older patients in steady treatment, and that the new centers have not yet spelled out whom they will serve or how.
In a field survey, 86.7% of local doctors expected fewer regular visits, and every pharmacist surveyed expected more patients to complain about costs.
Earning points means signing up and logging activities, so critics worry it cannot replace the old payments for older people who are not used to smartphones.
06How decisions will be made
The agency will form a reform committee with the government, local authorities, outside experts and staff from the existing centers. It will meet the Health Ministry regularly to check that the two programs connect, and consult the national health insurer, the insurance review agency and local medical associations.
It also plans briefings for local governments, clinics and patients on how registered patients move to the new system. Agency chief Lim Seung-kwan said prevention, early diagnosis and steady management matter most for chronic disease, and that the agency will work closely with people on the ground.
07What it could mean
Until now, people outside the 19 areas could not get this kind of care. If the plan works, more areas and younger patients will get education, counseling and reminders. High blood pressure and diabetes are common among Korean adults, so many people could be affected.
For older patients who now get payments, 2027 is a turning point. If they move smoothly to the points system, they could even get more money. But anyone who drops out during sign-up could stop treatment, and untreated high blood pressure and diabetes often lead to stroke, heart disease and kidney disease.
The open question is whether briefings and guidance actually bring older patients into the new system.
