North Korea is building model hospitals and pharmacies across the country while widening a new medical insurance program meant to ease the cost of treatment. Unstable medicine supplies and costly premiums, however, are limiting the benefits for many North Koreans.
“Every city and county is building a pilot hospital to modernize the hospital system,” a source in North Hamgyong province told Daily NK recently. “The authorities also set up model pharmacies and have already expanded them nationwide.”
The campaign follows Kim Jong Un’s call in February 2025 for a “revolution in public health” across North Korea. Kangdong County Hospital opened in November 2025 as the first regional hospital built under the campaign. State plans call for about 20 more such hospitals to open in 2026.
The state is also pouring resources into major pharmaceutical factories in Pyongyang and the provinces, the source said. Output is rising at the Pyongyang, Sunchon and Ranam pharmaceutical factories, which use both Chinese and domestic raw materials. Sunchon is an industrial city in South Pyongan province, while Ranam is a district of Chongjin.
North Korean authorities have repeatedly ordered these factories to produce and distribute essential medicines first, the source added.
Supplies nevertheless remain unstable, and medicine prices swing sharply depending on whether the factories are running. “When penicillin is produced properly, a 3-million-unit product sells for about 6,000 to 7,000 won,” the source said. “When production stops, the price climbs to anywhere from 30,000 to 50,000 won.”
The antibiotic Synthomycin typically sells for about 40,000 won per 800,000 units. A bottle of 120 Terramycin antibiotic tablets costs roughly the same amount. Aspirin sells for 25,000 to 28,000 won per 100 tablets, and a 500-milliliter bag of glucose IV fluid costs about 6,000 to 7,000 won. All of these prices spike whenever supplies run short in local markets, according to the source.
Medical insurance brings free care but strains poorer households
Alongside the hospital push, North Korea is expanding enrollment in its medical insurance program. The authorities present the program as a way to help people who skip treatment because of the cost.
“In the past, a single X-ray cost about 50,000 won, so many people couldn’t go to the hospital even when they were sick,” the source said. “The medical insurance system came about for exactly that reason.”
The program marks a notable shift for a country that has long promoted free universal health care. In practice, North Koreans have paid market prices for medicine and bribed doctors for treatment for decades. The state health system largely broke down during the famine of the 1990s and has never fully recovered.
The state runs the insurance through a system that links workplaces with hospitals. Premiums vary according to each member’s income level, the source said. Workers with jobs that pay above a certain salary contribute about 50,000 won a month. Those without jobs or with low wages pay around 5,000 won a month instead.
Some members already receive real benefits from the program, according to the source. Insured patients receive general consultations free of charge at their local hospital. The insurance also covers part of the cost of tests and surgeries that require extra payment: an X-ray that usually costs about 50,000 won costs insured patients around 25,000 won.
“If you join the insurance, treatment at the hospital is free, and tests like X-rays are half price,” the source said. “The insurance applies to surgery costs too, so the burden on patients is lighter.”
Surgery costs still vary widely depending on the type of treatment, with major operations such as cancer surgery costing about 300,000 won. Simpler procedures such as an appendectomy run anywhere from 50,000 to 60,000 won.
Many North Koreans, however, still find the premiums themselves hard to pay. Even the 5,000-won monthly fee weighs heavily on elderly people without a steady income, the source said.
“People with no earnings struggle to pay even 5,000 won a month,” the source said. “Traders who make relatively good money also try to hide how much they earn. Under this system, a higher income means they would have to pay higher premiums.”
North Korea’s push to modernize hospitals and boost drug production could still lower treatment costs for some families. With medicine supplies unstable and premiums straining poorer households, however, the real benefits will likely vary by social class.
This article was originally written in Korean and translated with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
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October 2, 2026 at 12:51AM
by DailyNK(North Korean Media)