• The Journal of the Korea Contents Association
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• v.13 no.4
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• pp.170-186
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• 2013

As the population is getting older, medical expenses amount of the whole is keep increasing. So, the pressure of the finances, Health Insurance, Medical Care Assistance Act and etc, is getting higher. The share of healthcare-expense is increasing due to elderly illness. And it became a social problem; we analysed present state of senior healthcare in South Korea-looked into current laws and policies, and found problems. We tried to suggest improvements that drew from the current state of foreign country senior healthcare of those problems. For the result, we found the problem in relevant-law system of senior healthcare guarantee. In this study, we proposed the ways to qualitatively upgrade of medical standard that considered on elderly' features: the strengthened guarantee for healthcare, financial secure for long-term convalescence benefit, linking and functional reinforcement for elderly welfare and long-term convalescence insurance, the solution for overlapped laws about convalescence in long-term convalescence insurance and elderly welfare, a betterment of grading, and a home service consolidation. We need to secure right amount of emergency medical service budget, and effective management system for the improved level of senior severely emergency medical service. Furthermore, we suggested that South Korea needs to legislate [The Law for Senior Medical Secure] to respond to rapidly increasing senior healthcare fee.

• The Korean Journal of Applied Statistics
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• v.30 no.3
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• pp.475-486
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• 2017

This paper estimates the health life expectancies for Korean people based on a sample cohort database collected through objective measurements by the National Health Insurance Service. Health life expectancy is estimated using the single-state approach of Sullivan (1971). The 9-order correction factor method of Greville (1945) and Brass-logit model of Brass (1971) are also adopted for unobserved or incompletely observed age-specific morbidity and mortality. Based on the mortality and morbidity estimated from sample cohort DB, men and women in Korea are expected to live a 'healthy life' for 61 and 60 years in 2013, respectively, whereas life expectancies of men and women are 80 and 87, respectively. We also estimate certain disease-free life expectancies for each of genders, income levels, and types of insurance from 2003 to 2013 in Korea. We found that there exists an inequality of healthy life expectancy in Korea for different genders, income levels, and types of insurance.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.11-40
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• 2012

National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to 'when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by 'gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete 'gross negligence' clause from above paragraph and to interpret 'when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.

• The Journal of the Korea Contents Association
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• v.17 no.9
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• pp.476-485
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• 2017

This study was analyzed obesity status by divided into six classification based on the body mass index(BMI) established by World Health Organization-Western Pacific Regional Office(WHO-WPRO) through National Health Insurance Service(NHIS). In the middle of process, problems of outlier solved by presenting the median repeated interpolation. Unlike linear and Lagrange interpolation, median repeated interpolation may be useful in multiple outlier contained dataset. As a result, we found that extreme low and obesity weight gradually increased and the frequency of normal body weight gradually decreased. Especially, the increase of obesity in men and women of lower age group is increasing. Overall, this study suggests that national measures need to be taken before health problems arising from obesity can spread to other social problems.

• 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.

• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.33-67
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• 2020

The hospitals that are owned by non-medical personnel result when non-medical personnel with resources conspire with newly graduated medical doctors who cannot afford the enormous amount of capital required at the beginning of the establishment of a medical institution. Such hospitals, though they may have met the external requirements as medical institutions, disrupt the medical market as it should be centered by medical personnels, In addition, such hospitals are causing a huge social problem as it is illegally receiving and reducing various benefits such as medical care benefits and subsidies from the government, resulting in a significant financial leak in the national health insurance. The illegality of the opening of a non-medical personnel hospital is so high that it nullifies the contractual arrangement for the establishment, imposes criminal penalties on all persons involved in the establishment under the Korean Medical Law, and imposes administrative sanctions on medical personnel. In case the hospital was aware of the illegality of its opening, but had applied to receive medical care benefits from the National Health Insurance Act and the Medical Care Act, such actions will result in the return of the benefits under the National Health Insurance Act and the Medical Care Assistance Act, subject to the penalty for the crime of fraud, and aggravated punishment for specific economic crimes based on the amount of gain, as well as civil liability for torts. In this study, we will examine the current status of the regulations on the non-medical personnel hospital and present the basis for future legislative directions by looking at the legal regulations and the attitude of the precedents.

• 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.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.185-209
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• 2014

While the local health insurance and the employment-based insurance were integrated in July 2000, the insured is divided into employment-based insured and the local insured and the relevant premium has been applied to both groups. The health insurance premium having the feature of social solidarity has to be determined depending on income, that is, the ability to pay in accordance with the principles of social insurance. While employment-based insurance premium has been determined depending on the earned income, the local insurance premium for the local insured has been determined by scoring gross income(evaluated income), property and possession of automobiles. A variety of improvement approaches has been implemented including introduction of the employment-based insurance premium ceiling system (2002) and the change of property scoring system for the local insured (2006). However, the health insurance system which was merged in 2000 has been implemented up to now without significant change even though there were lots of socio-demographic change including increase of income level and the population structure such as low birth and aging. In other words, it is required to implement the premium rating system securing the income-based equity. Nevertheless, it was inevitable to apply the diverse rating standards in the early stage because it was very difficult to verify the income of the self-employed. Although the income verification rate was significantly increased from 23% in 1989 to 44% in 2010, the irrational standards including property, automobiles, living standard and activity rate have been still applied to the local insured because it is difficult to secure the validity of insurance premium rating system and it severely lacks of security. This paper investigated whether the current insurance premium rating system for the local insured imposing the premium on the basis of 'gender' and 'age' complies with the basic human rights secured by the current Constitution of the Republic of Korea with respect to the practical and theoretic irrationality of insurance premium rating system and standards for he local insured. In accordance with the analysis results, this paper proposed the approach to improve the system.

• 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.

• 한국노년학
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• v.31 no.2
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• pp.259-276
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• 2011

If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.