Research on financial estimates to ensure dental care for North Korean residents after unification

Objectives:The purpose of this study was to estimate the financial cost required for dental health care coverage by integrating North Korea's free medical care system and South Korea's health insurance system, assuming the unification of North and South Korea.Methods: North Korea's health insurance and medical benefit finances were estimated based on the benefit content, benefit target, benefit level, dental service utilization rate, and dental care cost growth rate.Results: The results of the financial estimate assuming an average annual growth rate of dental medical expenses of 5% were as follows.Assuming that the proportion of health insurance recipients was 0% and the proportion of medical benefit recipients was 100%, health insurance was estimated at 0 won and government spending on medical benefits was estimated at KRW 771.9 billion in 2022.Assuming that the proportion of health insurance beneficiaries was 97% and the proportion of medical benefit recipients was 3%, health insurance was estimated at KRW 8,241.3 billion and government expenditure on medical benefits was estimated at KRW 510.9 billion in 2052.In addition, the financial estimation results assuming an average annual growth rate of dental medical expenses of 10% were as follows.Assuming that the proportion of health insurance recipients was 0% and the proportion of medical benefit recipients was 100%, health insurance was estimated at 0 won and government spending on medical benefits was estimated at KRW 808.7 billion in 2022.Assuming that the rate of health insurance beneficiaries was 97% and the rate of medical benefit recipients was 3%, health insurance was estimated at KRW 34.858 trillion and government spending on medical benefits was estimated at KRW 2.1608 trillion in 2052.Conclusions: If the rate of increase in dental medical expenditure is not controlled, it is possible that very high dental medical expenditure will become a significant social burden for both North and South Korea.A strategy needs to be developed to minimize the financial impact after unification and promote efficient integration of the dental healthcare system.