• Title/Summary/Keyword: 건강기금제도

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Hospice & Palliative Care Policy in Korea (한국의 호스피스완화의료정책)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.20 no.1
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    • pp.8-17
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    • 2017
  • Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

Die Auseinandersetzung und Harmonie von unterschiedlichen Ideen im Krankenversicherungssystem (의료보험체계에서 이념의 갈등과 조화 -의료보험에서 경쟁의 억제와 유인-)

  • Kim, Na-Kyoung
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.151-181
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    • 2009
  • Im koreanischen Gesundheitsversicherungssystem spielt die soziale Solidarit$\ddot{a}$t Hauptrolle bei unterschiedlichen gesundheitspolitischen Entscheidungen. Daher wird manchmal vernachl$\ddot{a}$ssigt, dass auch die Qualit$\ddot{a}$tsverbesserung der Medizin und der Umfang der von der Krankenversicherung unterst$\ddot{u}$tzten medizinischen Leistungen wichtige Elemente der Krankenversciehrung sind. Um die letztere zwei Ideologien zu verwirklichen, soll insbesondere das Prinzip der Konkurrenz funktionieren k$\ddot{o}$nnen. Aber im koreanischen System hat die Konkurrenz fast gar kein Platz f$\ddot{u}$r sich. Auch das deutsche GKV (Gesetzliche Krankenversicherung)-system versucht die Sozialversicherung zu sein. Aber den deutschen Krankenversicherungssystem sieht es-speziell mit dem Vergleich vom Koreanischenzumindest viele unterschiedliche Funktionssysteme immanent zu sein. Zum einen tendiert die Einf$\ddot{u}$hrung des Gesundheitsfonds und vom Einheitlichen Beitragssatz die Sozialsolidarit$\ddot{a}$t zu verst$\ddot{a}$rken. Zum anderen tragen aber die Systeme von Zusatzbeitrag, Pr$\ddot{a}$mien und Wahltarife dazu bei, bessere Qualit$\ddot{a}$t der medizischen Leistungen zu garantieren und die Pr$\ddot{a}$ferenz von Patienten ernst zu nehmen. Es ist zwar nicht einfach vorauszusagen, zu welchen Ergebnissen diese Elementen f$\ddot{u}$hren. Aber die Funktion der unterscheidlichen Elementen, die die Konkurrenz motivieren konnen, zeigen schon viele Andeutungen f$\ddot{u}$r die Ver$\ddot{a}$nderung des korenischen Systems.

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사학연금 지급개시연령 개선에 관한 연구 : 이은재의원 입법 발의안을 중심으로

  • Jeong, In-Yeong;Kim, Su-Seong
    • Journal of Teachers' Pension
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    • v.3
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    • pp.207-252
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    • 2018
  • 현행 사학연금법은 공무원연금법 제46조 제1항 제4호 "정원 감소로 퇴직한 때부터 연금 지급" 조항을 준용함에 따라 정원감축 및 폐교에 따른 퇴직을 할 경우 법에 명시된 연금지급 개시연령이 아닌 퇴직 후 5년 이후에 조기연금을 지급하도록 하고 있다. 본 연구의 목적은 현행 지급개시연령 규정의 타당성을 검토하고 개선방안을 제시하는데 있다. 이를 위해 사학연금 지급개시연령 현황 및 사립학교 폐교 현황과 사학연금이 공무원연금법을 준용함으로써 발생하는 문제점 및 현행 규정에 따른 연금지급 시 사학연금재정에 미치는 영향을 분석하고 법 개정의 타당성을 검토하여 개선방안을 모색하였다. 주요 연구결과는 다음과 같다. 65세 정년이 되어 은퇴하지 않고 중도에 퇴직하거나 고용이 취소되어 지급개시연령 보다 훨씬 일찍 조기연금을 지급하게 될 경우에는 퇴직연금 자체가 노후소득보장제도이기 보다는 실업급여의 성격으로 전락하게 되는 측면이 있다. 또한, 폐교에 재직 중인 교직원은 근로가 가능한 연령과 건강상태임에도 불구하고 즉시 연금을 수급하게 됨으로써 재취업을 하지 않을 경우 연금에 대한 의존성이 높아지고 근로유인을 저해할 수 있다. 그리고 최근 잦은 폐교로 인한 연금수급자 과다 발생 및 재정적 지속가능성의 문제가 있다. 또한 사학연금 가입자와 공무원연금 가입자의 특성을 비교하면 중요한 차이점이 발견된다. 국공립학교의 경우에는 해당 학교가 폐교 또는 정원이 감소될 경우 다른 지역 학교로 해당 재직 교직원을 이동 배치하는 등의 대처 방안을 시행하기 때문에 사실상 퇴직하는 사례가 거의 없는 반면, 사학연금 가입자의 경우 공무원연금 가입자에 비해 상대적으로 고용불안에 노출되어 있고, 학령인구 감소 등으로 인해 사립학교 폐교 가능성이 상존하므로 이들에 대한 생활안정대책이 필요하다. 또한 공무원 조직의 개폐 및 정원 감소는 법령으로 정하고 있지만, 사립학교 교직원의 개폐 및 정원의 감소는 사학기관의 특성에 따라 차이가 있다. 그리고 공무원의 경우 공무원연금의 대상이면서도 고용형태의 상대적 취약점을 감안하여 임기제 공무원의 경우 고용보험의 가입이 일부 허용되나, 사학연금 가입자의 경우에는 전면적으로 가입이 제한되어 직역연금 간 형평성 문제가 발생하고 있다. 그리고 국민연금과 비교할 때 다음과 같은 차이점이 있다. 국민연금법의 경우 사업장가입자로 적용받고 있다 하더라도 준용법과 같은 사립학교 폐교 시 조기연금 수급 규정이 없으며, 고용보험법의 적용으로 실직 시 실업급여 등의 대응책이 있긴 하나 연금 수급을 통한 소득보장 수준에는 못 미치는 제도적 보완책을 갖추고 있다. 또한, 국민연금 가입자는 고용보험에 적용되나, 사학연금 가입자는 실업상태에 놓였을 경우 고용보험의 적용을 받지 못한다는 점에서 차이가 존재한다. 이에 다음과 같은 개선방안을 제시하였다. 폐교 시 사학연금 가입자의 생활안정을 위해 고용보험 가입을 검토할 필요가 있고, 재정안정화를 위해 연금을 전액지급하기 보다는 퇴직일부터 지급개시연령까지의 잔여기간에 따라 차등지급하는 방안을 모색해 볼 수 있으며, 고용보험법상의 실업급여 제도를 원용하고 소정의 연금지급기간을 설정하여 연금을 지급하는 방안을 고려할 필요가 있다. 이에 더하여 사학연금제도 내에서 별도의 고용보험기금을 마련하는 방안도 모색해볼 필요가 있다.

A Case Study on the UK Park and Green Space Policies for Inclusive Urban Regeneration (영국의 포용적 도시재생을 위한 공원녹지 정책 사례 연구)

  • Kim, Jung-Hwa;Kim, Yong-Gook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.5
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    • pp.78-90
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    • 2019
  • The purpose of this study is to explore the direction of developing policies for parks and green spaces for inclusive urban planning and regeneration. By reviewing the status, budget, and laws pertaining to urban parks in Korea, as well as assessing the inclusivity of urban parks, this study revealed the problems and limitations in Korea as follows. First, the urban park system, which takes into account indicators such as park area per capita and green space ratio, is focused only on quantitative expansion. Second, the distribution of urban parks is unequal; hence, the higher the number of vulnerable residents, the lower the quality of urban parks and green spaces. Moreover, this study focused on the UK central government, along with the five local governments, including London, Edinburgh, Cardiff, Belfast, and Liverpool. Through an analysis of the contexts and contents establishing UK park and green space policies that can reduce socioeconomic inequalities while at the same time increase inclusiveness. This study discovered the following. The government's awareness of the necessity of tackling socioeconomic inequalities to make an inclusive society, the change in the urban regeneration policies from physical redevelopment to neighborhood renewal, and the survey and research on the correlation of parks and green spaces, inequality, health, and well-being provided the background for policy establishment. As a result, the creation of an inclusive society has been reflected in the stated goals of the UK's national plan and the strategies for park and green space supply and qualitative improvement. Deprived areas and vulnerable groups have been included in many local governments' park and green space policies. Also, tools for analyzing deficiencies in parks and methods for examining the qualitative evaluation of parks were developed. Besides, for the sustainability of each project, various funding programs have been set up, such as raising funds and fund-matching schemes. Different ways of supporting partnerships have been arranged, such as the establishment of collaborative bodies for government organizations, allowing for the participation of private organizations. The study results suggested five policy schemes, including conducting research on inequality and inclusiveness for parks and green spaces, developing strategies for improving the quality of park services, identifying tools for analyzing policy areas, developing park project models for urban regeneration, and building partnerships and establishing support systems.

The Present State of Marine Oil Spills and the Enhancement Plans of National Oil Spill Response Capability in Vietnam - Through the Comparison of Statistics and OSR System between Vietnam and Republic of Korea - (베트남의 해양기름유출 현황과 국가대응역량 증강 방안 - 통계자료와 유출유 방제시스템에 대한 베트남과 한국 간의 비교를 통하여 -)

  • Phan, Van Hung;Kim, Kwang-Soo
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.23 no.6
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    • pp.690-698
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    • 2017
  • Vietnam is a marine nation with more than 3,444 km of shorelines, thousands of islands, and 2,360 rivers and canals of over 42,000 km long. As the frequency and the volume of oil transportation by ships increase, the possibility of oil spill incidents becomes higher than ever. Fuel oil and cargo oil spills at sea have widespread impact and long-term consequences on marine ecosystems, coastal resources and human health as well as socio-economy. This study is to show not only the present state of marine oil spills in Vietnam such as the number and the volume of oil spills for two decades, and an overall about Vietnamese national response system like national framework for Oil Spill Response (OSR), etc. but also to present the recommendations for enhancing national capability in response to oil spill incidents in Vietnam, especially, with a comparison of national OSR systems between Vietnam and South Korea. As the result, the number and the volume of marine oil spills in Vietnam showed an upward trend as opposed to a downward trend in South Korea. This means that Vietnam has the possibility of oil spills in coastal waters. Therefore, three main recommendations for the enhancement of national OSR capability in Vietnam are proposed as follows: (1) the development of alternative plan for reenforcing national OSR system involving legal system for preparedness and response to oil spill pollution such as the acceptance and implementation of OPRC Convention as well as the establishment of national fund compensating for the damage and loss caused by oil pollution; (2) the enhancement of a consistent reporting, alerting and monitoring system; and (3) the development of training and exercise programs with standard contents of educational courses.