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The debate over the government's push to expand health insurance coverage for hair loss treatment shows no signs of cooling down. While proponents argue that the financial burden of treatment must be reduced as hair loss is increasingly viewed as a matter of survival rather than a mere cosmetic issue, a formidable counterargument emphasizes the deteriorating state of national health insurance finances. With patient advocacy groups also raising fairness concerns over the priority of health insurance funding, the policy is expected to face a bumpy road ahead.

According to the Ministry of Health and Welfare on June 16, the ministry, in collaboration with the Ministry of the Interior and Safety, will host the "1st Forum for All" on July 4 to gather feedback from 200 citizens regarding the expansion of health insurance coverage to hair loss medications. Expanding coverage for hair loss treatment was a campaign pledge made by President Lee Jae-myung during the 2022 presidential election, and he directed a review late last year during a briefing, stating, "I consider hair loss to be a matter of survival."

Under the current system, health insurance covers certain conditions like alopecia areata, but androgenetic alopecia—commonly known as male-pattern baldness—is excluded. According to the Health Insurance Review and Assessment Service, the number of patients treated for hair loss stood at 237,332 in 2024, down slightly from the previous year but still maintaining the 200,000 range. Meanwhile, some industry circles, including the Korean Hair Loss Society, estimate that the actual number of hair loss sufferers in the country reaches up to 10 million.

The Welfare Ministry has completed its working-level review and surveys ahead of next month's forum. During a press conference on June 11 marking the first anniversary of the administration's launch, Health and Welfare Minister Jung Eun-kyeong said, "We have conducted a working-level review on the projected fiscal spending if health insurance is applied to hair loss treatment," adding, "A survey of 1,000 people conducted by the National Health Insurance Service also yielded mostly positive responses."

The primary benefit expected from expanding health insurance coverage is the reduction of the financial burden on patients. As young people are particularly sensitive to hair loss due to job-seeking and other social factors, the ministry is currently considering prioritizing coverage for youth aged 20 to 34. Proponents also argue that expanding coverage could help prevent overtreatment, which has been an ongoing issue.

The problem, however, is the continuous deterioration of health insurance finances. The National Health Insurance's current account surplus, which stood at 4.1276 trillion KRW in 2023, plummeted starting the following year to just 499.6 billion KRW last year, making a deficit highly likely this year. According to a report by the National Assembly Budget Office, the cumulative health insurance reserve fund, reflecting the first and second implementation phases of medical reform, is projected to be depleted by 2029. With fiscal sustainability already threatened by rising medical expenditures due to rapid population aging and investments in medical reform, introducing coverage for hair loss treatment would impose yet another financial burden.

Some patient advocacy groups are actively opposing the expansion, citing issues of fairness in funding priorities. The Korea Serious Illness Association issued a statement on this day, asserting, "Expanding coverage for hair loss treatment directly undermines the medical necessity and funding priorities that form the very foundation of health insurance." They added, "Discussing coverage expansion will accelerate the deterioration of health insurance finances and could ultimately push patients who are in desperate need of urgent treatment into a corner."

                                                                                                          Seo Byung-joo