Reorganizing decision-making to strengthen the insurer's role. Setting premiums, a key part of managing health insurance finances, directly affects members. It is therefore desirable to increase members' participation in setting premiums, and the insurer acting for members should be given the authority and responsibility to set premiums reflecting their views. To make the insurer's responsibility for managing the finances clear, it should be able to manage them in practice. Premiums should be decided through the Financial Management Committee of the National Health Insurance Service, and fees should be set through negotiation between the insurer and the providers, the medical institutions. Premiums are the core of insurance revenue. From the days of the Medical Insurance Act until the Special Act on the Financial Soundness of National Health Insurance was enacted, premiums were decided by the societies' operating committees and the Service's Financial Management Committee. In principle, members who bear the cost should take part in setting premiums based on future insurance finances. Health insurance is now divided into employee members and local members, whose types of income and rates of income identification differ, so a consultation process is needed in which the two groups adjust their shares of the burden to fix premiums. In short, it is reasonable for members to decide the share they pay. So the current structure, in which the Health Insurance Policy Deliberation Committee, where providers also take part, sets the premium rate, is undesirable. Setting the premium rate should be returned to the Financial Management Committee, a body that can fully reflect members' views, to raise public participation.

Korea has enacted various laws to address people's health problems and has given the state a duty to guarantee people's health. Among them, the National Health Insurance Act can be called the law that sets out the rational procedures and methods for deciding which medical services to provide, how to pay for them, and from whom and how much to collect. Under Article 4 of the current act, the Health Insurance Policy Deliberation Committee in practice decides all the main matters of the insurance program, from benefit standards and premium rates to relative value scores, fees for drugs and treatment materials, additional benefits and coverage of members.

To add: the National Health Insurance Act was enacted in 1999 and took effect in July 2000, and the employee and local funds were merged in July 2003. The Health Insurance Policy Deliberation Committee is still chaired by the Vice Minister of Health and Welfare and deliberates and decides premium rates and benefit standards (Article 4), and a comprehensive national health insurance plan is drawn up every five years (Article 3-2). Fees for covered care are already set by contract between the head of the Service and representatives of the medical professions, and the committee decides only when no contract is reached (Article 45). The 2026 premium rate for employee members is 7.19%.