Smoking, drinking cost Korea $20.5 billion in health insurance spending over 5 years

Over the past five years, health insurance expenditures from smoking and alcohol consumption have totaled nearly 29 trillion won -- equivalent to 4.4 percent of the 2024 government budget of 656.6 trillion won.

According to data submitted to Rep. Kim Sun-min of the Rebuilding Korea Party by the National Health Insurance Service (NHIS), health insurance expenditures attributable to smoking and alcohol consumption from 2020 to 2024 amounted to 28.5 trillion won ($20.5 billion). Health insurance expenditures due to smoking amounted to 15.3 trillion won, while those due to alcohol consumption reached 13.2 trillion won.

Last year alone, health insurance payments due to smoking totaled 3.49 trillion won, and those due to alcohol consumption totaled 3.01 trillion won, reaching 6.5 trillion won in total expenditures from the health insurance system. This represents a 32.5 percent (1.5 trillion won) increase compared to five years ago in 2020.

The distribution of patients related to smoking and drinking revealed a pattern of concentration among older adults. Last year, the total number of health insurance patients related to smoking was 2.65 million, with those aged 60 and above accounting for 1.69 million, or 64.0 percent of the total. The number of alcohol-related patients was 3.18 million, with 1.85 million (58.2 percent) being 60 or older.

Smoking and drinking not only increase the risk of disease but also place a direct burden on the national health insurance finances. While support for smoking-related problems is provided through the Health Promotion Fund, which is funded by tobacco levies, there is currently no financial support from the national health insurance for alcohol-related problems.

The amount supported by the Health Promotion Fund for smoking-related health insurance expenditures totaled 1.82 trillion won in 2023. However, insurance payments the same year totaled 3.28 trillion won, resulting in a smoking-related health insurance deficit of 1.46 trillion won. This deficit more than doubled from 726 billion won in 2020.

“Smoking and drinking are not merely individual lifestyle issues but major factors that have caused over 28 trillion won in health insurance expenditures over the past five years,” Rep. Kim said. “As health insurance spending due to these practices continues to rise, we must strengthen prevention-centered health policies.”

Kim continued, “Despite over 13 trillion won in health insurance payments being made on alcohol-related problems over the past five years, there are still no health insurance support measures specifically targeting alcohol consumption,” she noted, adding, “The government must discuss with experts and develop comprehensive measures to reduce the social costs of smoking and drinking while ensuring the health insurance system is managed on a sound financial footing.”