Browse > Article
http://dx.doi.org/10.4332/KJHPA.2003.13.3.052

Suggestion for Reform of Korean Medical-Juridical-Person System: through review on for-profit ownership of Korean medical institutions  

정형선 (연세대학교 보건행정학과)
이해종 (연세대학교 보건행정학과)
김정덕 (연세대학교 보건행정학과)
Publication Information
Health Policy and Management / v.13, no.3, 2003 , pp. 52-70 More about this Journal
Abstract
The rate of conversion to Medical-juridical-persons' ownership of medical institutions has increased rapidly since its start in 1970s in Korea. The most sensitive issue to introduce for-profit medical institutions, ignited particularly by the WTO/DDA negotiations, has sparked considerable debate, stemming largely from conflicting views on the theoretical effects of ownership status on organizational behavior. This study surveyed health-related experts' opinions on allowing for for-profit-firms-owned medical institutions. Some fear that the obligation to maximize the share-holders' return on their investment will cause the medical institutions to eliminate necessary but less lucrative services. They may easily fall under more pressure to generate income, and respond more aggressively than not-for-profit medical institutions to financial pressures. Advocates of for-profit ownership of medical institutions argue that greater responsiveness to the demands of the marketplace will lead to larger investment, higher quality and lower costs to consumers. Referring to both foreign countries' experience and domestic experts' opinions, this study suggests for reform of the current Korean Medical-Juridical-Person(MJP) System. Introduction of so-called “Capital-investment” MJPs is recommended where the properties left in case of their dissolution can be distributed to original investors according to the procedures stipulated in their statutes. However, their annual profits are not allowed to be allocated to investors, but should be reinvested for their medical institutions, as is the case in current MJPs. Their legal aspects are also reviewed in this study.
Keywords
Ownership of hospitals; For-profit; Not-for-profit; Investor-owned hospitals; Medical-Juridical-Person (MJP);
Citations & Related Records
연도 인용수 순위
  • Reference
1 Garg PP, Frick KD, Diener-West M, Powe NR. Effect of the ownership of dialysis facilities on patients' survival and referral for transplantation. New England Journal of Medicine. 1999;341(22):1653-1660.   DOI   ScienceOn
2 최기원. 상법학원론. 신정3판. 서울 : 박영사. 1998.
3 김준호. 민법총칙. 서울:법문사;2000.
4 實藤秀志. 医療法人ハソドブック. 東京. 稅務経理協會, 2003.
5 Silverman EM, Skinner JS, Fisher ES. The Association between for-profit hospital ownership and increased medicare spending, New England Journal of Medicine. 1999;341(6):420-426.   DOI   ScienceOn
6 Woolhandler S, Himmelstein DU. Costs of care and administration at for-profit and other hospitals in the united states, New England Journal of Medicine. 1997;336(11):769-774.   DOI   ScienceOn
7 西村周三(ed.). 医療経營白書. 東京. 日本医療企畵, 2002;402-405.
8 Dranove D. The Economic Evolution of American Health Care. Princeton. Princeton University Press;2000. pp.7-27.
9 Goldsmith J. Integrating care: A talk with Kaiser Permanente's David Lawrence. Health Affairs 2002;21(1).
10 Kleinke JD. Deconstructing the Columbia/HCA investigation. Health Affairs. 1998;17:7-26.
11 Hasan MM. Let's end the nonprofit charade. New England Journal of Medicine. 1996;334:1055-1057.   DOI   ScienceOn
12 津田光夫. 苦惱する市場原理のア刈カ医療. 東京. あけび書房, 2001.
13 Schlesinger M. Non-profit and for profit medical care: Shifting roles and implications for health policy, Journal of Health Politics, Policy, and Law, 1987.
14 Meurer JR, Kuhn EM, George V, Yauck JS, Layde PM. Charges for childhood asthma by hospital characteristics, Pediatrics. 1998;102(6).
15 이해종, 정형선, WTO/DDA의료시장 개방논의에 따른 병원산업발전방안. 서울 : 연세대학교보건과학연구소;2003. 보건복지부 연구비지원
16 墖井勝. 特定.特別医療法人の設立.運營. 東京. かんき出版, 2000.
17 Schiff GD. Fatal distraction: finance versus vigilance in U.S. hospitals, International Journal of Health Services. 2000;30(4):739-743.   DOI   ScienceOn
18 李啓充. 市場原理に搖られるア刈カの 医療. 東京. 医學書院, 2001.