Monday, October 26, 2009


Thus far, my reintroduction to Korean society has been unexpectedly bumpy at best for various reasons, but there are some aspects of life in Korea which would have to go a long way downhill before they become negative parts of the equation. One of these is the Korean health system with its immediate treatment, availability of hospitals with their second and third opinions if you want them, all at a price which show up the National Health Service back home for what it is - a self-absorbed and expensive bureaucracy which two years ago Wikipedia alarmingly cited as the fourth biggest employer in the world. By comparison, the privately-based Korean system seems much more certain to actually treat illness effectively. However, there is a catch - which is the money.

The reality is that the Korean system works very well so long as you can afford to pay for it, but you're probably out of luck if you can't. This means you really need to have health insurance - at least for the more expensive treatments. Some may argue that's inferior to the British system, and perhaps it is in certain circumstances, but when I suffered the onset of mysterious back pain earlier this year that left me unable to walk for a month - the most the NHS could offer me was a three month waiting list for an MRI which I instead paid £650 (1,260,000 won/$1,064) to have done privately within a week - which is still something a Korean hospital might have been able to do within a day at a third of the cost in my experience.

Despite the relatively low-cost of procedures in Korean hospitals - and while I hope I will always have the resources to cover any ill health I experience - last week I decided to hedge my bets and arrange for an insurance quotation for myself. This involved bringing in a personal contact of Korean Mother, who works in this area. She visited us at home and while discussing the various options, bemoaned the fact that these days, "young people" tended to forego the 'social network' approach to obtaining a policy, but would instead shop around on the Internet or ask a lot of questions about the fine detail of the policy if they did come to see her. I got the distinct impression that in the good old days, the way this worked was for the personal contact to recommend a policy, which would then pretty much be blindly signed up for in the belief that if anything happened they would somehow magically be covered because their personal contact had arranged it, and they would never do anything that would disadvantage them. I became painfully aware I was asking a lot of questions through my translator.

The first thing I had to get my head around was the notion that while there seemed to be two types of insurance - "health" and "life", these are not the same concepts I am used to. The far cheaper "Health" insurance covers small diagnostic procedures and, oddly enough, a certain amount of legal protection should I ever be sued for causing damage to other people's property, or injury to third parties. I've read recently that Korea is quite a litigious society and while I was not aware of this allegation beforehand, I can well believe it from certain anecdotal evidence I am aware of within our social network, so this seems like a theoretically useful policy to have, especially as the whole package costs around £21 (40,500 won/$34) per month.

The much more expensive "Life" insurance covers larger diagnostic procedures as well as drug and operative treatments, although I was disappointed to discover the ceiling for cancer-related payments was only 20,000,000 won (£10,000/$17,000), which seemed very small. There was a lot more included though, so in principle the proposed policy had its attractions. I was aiming for a monthly cost of around £90 (174,000 won/$147) because this was the equivalent of what I would be paying in the UK, although it's very hard to compare like-with-like considering that Korean policies are so different. So I was taken aback to be quoted an annual cost approaching £1,500 - £1,750 (3,150,000 won/$2,661) if you include the "health" insurance on top of it. Friend or no friend, I was ready to show her the door, even when it was explained that I would only pay this amount for 20 years - after which I would be still covered for life with no additional premiums. This struck me as the health insurance equivalent of a Government-sponsored national pension pyramid scheme, where people paid relatively small premiums 20-30 years ago based on the seemingly ridiculous assumption that life expectancy and health costs would not rise considerably with future technological improvements. I couldn't see the insurance company keeping their system working if average life expectancy rose to 100 in the foreseeable future, which to my mind is entirely possible. I was dubious.

But the next big shock sealed the deal. It was too expensive to my mind, but I thought I could sign up and find a better deal in the next few months when I had the time to research the market properly, so I asked about penalty clauses for withdrawing from the scheme. This caused some nervousness on the part of the insurance agent - she explained that as we were a 'personal contact' she would be paying our first month's bill (probably from her bonus I thought), so it would 'look very bad' if we pulled out after only one or two months. If this happened, it seemed she would be sent for 're-education' within the company, something which had an unpleasantly North Korean feel to it. However, the real surprise was that if I withdrew, I'd get just under 69% of my premiums back - which stopped the scheme looking so expensive after all, although in some senses while they are dangling the carrot of a fixed 20-year payment plan, on the other hand it takes on aspects of a long-term - admittedly zero-interest - savings scheme. So I signed up, utterly unconvinced as I am that it is competitive or realistic. There is a lot happening right now, of which the health and life insurance is only a minor part, so there is an element of putting something in place and moving on.

The insurance agent went away and returned later in the day with the formal papers for signing, and there was a lot to be signed - so much in fact I wondered whether I was getting health insurance or promising my eternal soul to the company. I counted nine separate signatures, and because my wife is the named payer on the principle that only she can have read the considerable number of terms and conditions and understood them, she got to sign her name around fifteen times on the same documents. Unfortunately this also points out a rather sad reality about my future in Korea - it's one thing to understand social conversations, but it's going to take a long time before my understanding of the language is anywhere near good enough to understand legal contracts and the kind of small print which appears within them. There is a very, very, long way to go.

Later, the insurance company phoned me up to ensure that I'd signed up willingly to the policy because I'm a foreigner and I couldn't have understood what I was signing. But there was a problem - they couldn't speak English on the phone - so the laughable way this ended up working is with them asking a question in Korean to my wife, who passed over the phone to me with instructions on whether to say 'yes' or 'no' in Korean to the person on the other end of the line. Then I passed the phone back and we moved on to the next question. How this proves anything is anyone's guess. Corporate Korea hasn't quite worked out how to deal with foreigners as customers of their services, but I should be grateful that they even let me be a customer - it's not always guaranteed.

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