Abstract
The Korean government sought to include dental implant services for the elderly in the benefits package of the national health insurance. In 2014, the Citizens’ Jury was held to discuss the topic, during which thirty jurors, randomly selected from the 2665 applicants, participated in a day-long deliberation process after having an information session on the topic by a team of experts. There was a substantial shift in opinion during the deliberation session toward a more cost-conscious view. Most jurors supported limiting the coverage of dental implant to only one tooth per individual given the extent of the financial burden that will be imposed on the population. They opposed covering implant services for the front teeth, given that the implant of front teeth generally serves aesthetic purposes rather than restoring mastication function. The government’s final decision in 2014 was to offer coverage up to two teeth, regardless of tooth location. This scheme based on the jury’s recommendations in 2014 has been implemented without policy failure to date, which shows that the lay public can meaningfully contribute to a decision-making process regarding controversial agendas such as benefits packages for expensive health services.
Highlights
Previous studies have demonstrated a positive association between tooth loss and increased risk of dementia, depression, and anxiety in adults [3,4]
This study aims to examine the process, the findings, recommendations of the Citizens’ Jury on the optimized resource allocation for dental implant service to provide an example for other countries in consideration of the public coverage of dental implant services
The jurors’ poll results on each question as well as rationales for the opinions were summarized by National Health Insurance Service (NHIS) on behalf of the jurors and submitted to the Health Insurance Policy Deliberation Committee (HIPDC) in a document for the final decision
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Public Health 2021, 18, 4135 almost to the average monthly income of the elderly (equivalized disposable income for the elderly ≥65 was 1140 thousand KRW in 2013 (≈1101 USD)) [5,6] This circumstance has led one of the leading candidates (and elected) in the election for the 18th President of Korea to publicly promise insurance coverage expansion for dental implant service for the elderly over 65 years of age. This was criticized as a political move rooted in populism to appeal to the elderly voters and faced strong opposition. The President continued to pursue the promise after the inauguration in 2013 with a plan to start coverage of dental implant services from 2014 for the elderly aged more than 75 with 50% co-payment and to extend by lowering eligible age for benefit gradually from 75 to 70 in 2015, and 65 in 2016
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