This article was originally published by Radio Free Asia and is reprinted with permission.
Some North Korean hospitals are posting prices for treatment and medicine in a break from past practice that suggests authorities are abandoning the goal of providing free health care, sources in the country have told Radio Free Asia.
The communist country’s Public Health Act stipulates that the state provides complete and comprehensive free care. While the reality has long been different, with patients paying for medicines and other expenses out of pocket, now prices are being openly displayed, according to two sources in two different provinces.
“Recently, hospitals in the province have changed their signs and begun displaying medical fees inside the buildings,” said the first source in North Hamgyong province who requested anonymity for safety reasons. “As soon as you enter the hospital, the fees are posted prominently at the reception area.”
The source said hospitals began posting treatment fees in February and that many residents were “quite shocked.” In the past, residents were used at least to getting consultations for free, even if they had to pay out for medicines.
The source in North Hamgyong province, which lies in the northeast of the country, said that since fall 2024, hospitals also began changing their names from “people’s hospitals” to names based on the district or city, and began posting treatment costs as well.
Fees are listed in the reception area of hospital, such as 5,000 won (25 to 50 cents) for registration, 5,000 won for consultation, 20,000 won ($1 to $2) for an X-ray, and 50,000 won ($2.50 to $5) for medical certificates, according to a second source in North Pyongan province, which lies in country’s west. Also displayed are prices for various medicines, including painkillers and antibiotics, ranging from 200 won (1 to 2 cents) for an aspirin tablet, to 8,000 won (40 to 80 cents) for penicillin.
In theory, North Korea has universal health coverage but its ability to provide it has been hamstrung for decades by chronic shortages, which grew acute after the fall of the former Soviet Union and the subsidies it offered, and then famine in the late 1990s. Anecdotal evidence indicates a pervasive lack of basic amenities such as electricity at clinics and hospitals.
Independent research on the North Korean health care system, based on responses from North Koreans who fled to South Korea and published in 2020, actually suggests that out-of-pocket of expenditures for health services have been widespread for years, even for medical consultations. More than 80 percent of the 383 respondents in the research said they had paid for medicines and medical supplies.
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