North Korea appears to be preparing a major shift in how it funds health care, seeking to fix a broken system that has increasingly fallen outside state control.

For most of the DPRK’s history, free medical care has been a basic promise of the communist state, with the government paying to build hospitals and provide health care to the people.

But a recent report stating that a national health insurance system is under development suggests that Pyongyang is rethinking this sacred cow, in large part because free health care has not been the reality