First, the study by Jaehoon Lee et al.² examines the current status of paid sick leave and sickness benefits, focusing on OECD countries. The International Labor Organization (ILO) has established standards for sickness benefits regarding eligibility, coverage, duration, and benefit levels. Among the 33 OECD countries, 21 comply with these standards. In countries with operational sickness benefit schemes, the benefits tend to be both adequate and inclusive. Second, Jinwoo Lee highlights the urgent need for the legislation of the sickness benefit system in South Korea and the compliance with ILO standards, providing supporting evidence. In the absence of paid sick leave, presenteeism—the act of working while sick—is common and detrimental to public health.³ Access to sick leave varies sharply by workplace size and employment type: only 6.9% of workers in workplaces with fewer than five employees are provided sick leave, compared to over 70% in companies with 300 or more employees. This stark inequality poses a serious threat to health equity. Third and fourth, the papers by Yangwoo Kim and Inah Kim^4,5 review the conceptual framework and international cases that should be considered when establishing an assessment system for medical judgment during the implementation of the sickness benefit system. Finally, Daseul Moon and Hongjo Choi⁶ summarize the discussion and outline the tasks required for the introduction of a Korean-style sickness benefit system.

Illness often reduces work capacity, leading income loss and increased medical expenses. This dynamic can drain health resources and trigger a cycle of poverty where poor health is both a cause and consequence of economic hardship. Addressing this requires more than just covering medical costs—it demands compensation for income lost during illness. Paid sick leave is a social investment that safeguards health rights, prevents poverty and supports sustained productivity. To achieve universal health coverage, South Korea must implement a sickness benefit system that offers meaningful, nondiscriminatory support to all citizens. Legislative reforms, including amendments to the Labor Standards Act and National Health Insurance Act, are necessary to establish a robust and inclusive income protection system.

The introduction of a Korean sickness benefit scheme is not merely a welfare expansion—it represents the establishment of a new social right. It must account for the realities of today’s diverse labor market, including non-standard and precarious forms of employment. Current pilot projects reflect existing inequalities in the Korean labor market, making it imperative to adopt a systematic approach that incorporates health equity and gender sensitivity throughout policy design, implementation, and evaluation processes. Moreover, the work capacity assessment system must shift from a binary evaluation of work incapacity to a focus on work fitness, strengthening medical certification frameworks similar to Sweden’s disease-specific guidelines and the UK’s “fit note” system.

The potential benefits of introducing the sickness benefit scheme are clear.⁷ First, it would reduce health disparities based on employment conditions, thereby improving health equity. Second, it would support timely treatment, faster recovery, and return to work, thereby minimizing productivity losses. Pilot program data already show that benefit recipients are more likely to return to work and less likely to transition to economic inactivity than non-recipients. Third, the system could combat social exclusion by extending protection to workers in small and medium-sized firms and non-standard employment, who have historically been marginalized from existing social security systems.

To achieve these goals, paid sick leave must be enshrined in law through amendments to both the Labor Standards Act, and the National Health Insurance Act. Integrating a people-centered and health equity-oriented approach into the development and implementation of the system will enable South Korea to move beyond patchwork solutions through policy supplementation and take meaningful steps toward reducing health inequalities and structural injustice.

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