• Title/Summary/Keyword: 건강보험제도

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노무관리-건설공사 노무제도 및 실무(4)

  • Korea Mechanical Construction Contractors Association
    • 월간 기계설비
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    • no.2 s.211
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    • pp.71-74
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    • 2008
  • 대한설비건설협회 전국 시·도회는 최근 개정, 시행되고 있는 건설 노무관련제도와 국민연금.건강보험 사후 정산제 등 사회보험 실무에 대해 회원사들의 이해를 돕기 위해 노무강습회를 실시했다. 이 강습회에서 서울특별시회 자문 노무사이자 노무법인 한길 본사 대표인 신흥식 노무사가 사회보험실무와 최근 개정 시행 중인 노무제도 등을 강의하고 질문과 답변을 통해 그동안 회원사들이 궁금해 했던 내용을 설명했다.

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Problems of National Medical Expenses Management in Korea (한국 국민의료비 관리의 문제점 분석 : 건강보험, 산재보험, 자동차보험을 중심으로)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.263-272
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    • 2011
  • The purpose of this study is suggesting proper management methods for the national health expenditures by considering advanced countries and analysing the problems of national health expenditures management in korea. The majors results of the research are as follows. First, most advanced countries is integrating the management of national health expenditures about health insurance, workmen's accident compensation insurance and auto insurance etc, and medical prices and benefit standards are same regardless of insurance type. Second, national health expenditures has been managing separately by national health systems in korea, and there are many problems like the differences medical expenditure review and payment, medical prices and benefit standards etc. Although same symptoms and disease, there is great difference in health service utilization. Hereafter, management system of national health expenditures must be integrated, and must change same medical prices and benefit standards.

A study on the characteristics of severe trauma patients by health insurance system (건강보험제도에 따른 중증외상 환자 특성 비교 연구)

  • Choi, Mi-Young;Lee, Hyo-Ju;Yun, Seong-Woo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.309-313
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    • 2022
  • This study was attempted to analyze the status of emergency room use of severe trauma patients using the health insurance system and to understand their characteristics. This study used data from the 'Community-based Severe Trauma Surveillance' investigated from January 1, 2018 to December 31, 2019. As a result, there were differences in the degree of disability after injury and whether treatment(surgery, trauma embolism, transfusion) was performed according to the type of medical insurance (p< .001), it was found that there was a statistically significant difference between the degree of disability before and after damage depending on the type of medical insurance (p< .001). Reviews of the health insurance system located for the well-being of the people should be continued from various angles, and specific improvement plans should be proposed.

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A Study on Strengthening of Health Care Protection and Sustainability Plan (건강보험 보장성 강화 및 지속가능성 제고 방안 연구)

  • Jung, Yong-Ju
    • The Journal of the Korea Contents Association
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    • v.21 no.4
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    • pp.96-110
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    • 2021
  • Korea is faced with the challenge of adapting to the world's fastest - growing low birthrate, aging society, and low growth with low interest rate era. With low fertility and aging population, the factors of financial income of health insurance are decreasing, and the increase of public interest in health, high cost medical technology and the development of medicine are leading to increase expenditure of health insurance. In this study, I will examine the strengthen protection of health insurance, financial stabilization, and fairness of medical care. First, the present status and limitations of health insurance were identified through domestic policy report, domestic and foreign literature, and precedent research. Second, the foreign health insurance policy measures to stabilize the finances were examined separately. Based on this study, in order to maintain sustainable health insurance through reinforcement and financial stabilization of health insurance, the current financial income structure of health insurance must be renovated. It will be necessary to expand government subsidies and discover new tax revenues. In addition, a policy to save finances by reorganizing the medical bill payment system and medical delivery system will also be needed.

Interaction between Out-of-Pocket Maximum and Indemnity Health Insurance (본인 부담상한제와 민영 실손의료보험의 상호작용)

  • Young-Hee Nam
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.667-673
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    • 2024
  • This study aims to diagnose the issues arising from the relationship between the out-of-pocket maximum in health insurance and private indemnity health insurance and propose policy tasks for institutional improvement. Through literature research, the study analyzed the damage to consumers caused by the non-payment of refunds exceeding the out-of-pocket maximum and the changing role of indemnity insurance due to the strengthening of health insurance coverage. The results confirmed that unilateral interpretation of insurance clauses and incomplete sales practices infringe upon consumer rights, and that insurance premiums do not decrease despite the reduction in coverage of indemnity insurance. Therefore, the study emphasized the urgency of institutional improvements such as rationalization of product structure, transparency of risk rate calculation, and reinforcement of consumer information provision, as well as the need for social consensus on the rational division of roles between health insurance and private insurance. This study is significant in that it provides policy implications for the developmental reorganization of the healthcare system.

A Study on an Integration of the Entitlement, Collection and Payment in the Social Insurance Systems of Developed Countries - Focusing on the Historical Review of Institutional and Organizational Integration - (선진국 사회보험에서 적용.징수.급여업무의 통합사례에 관한 연구 - 제도통합과 조직통합에 대한 역사적 고찰을 중심으로 -)

  • Nam, Chan-Seob;Baek, In-Rib
    • Korean Journal of Social Welfare
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    • v.63 no.2
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    • pp.5-29
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    • 2011
  • This paper analyzed the integration cases of the social insurance systems of Germany, Sweden and United Kingdom. On the basis of the two dimensions - institutional and organizational integration, this study reviewed the historical processes of the social insurance integration of the three countries. In Germany, the institutions and the organizations are divided still now and the sickness insurance funds take charge of the entitlement and collection services. In Sweden, the social insurance system is divided by institutions but the organizations were united. the Inland Revenue has charge of the entitlement and collection. In UK, the institutions and the organizations were united and the entitlement and collection services is assigned to the Inland Revenue. Regarding these historical processes of the social insurance integration of developed countries, this paper evaluated the transfer of the collection service to the National Health Insurance Corporation in Korea, which was enforced in 2011.

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2002년 건강보험재정현황 및 전망

  • Han, Man-Ho
    • Journal of the Korean hospital association
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    • v.31 no.2 s.276
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    • pp.11-21
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    • 2002
  • 건강보험 재정위기는 장기적으로 누적되어 온 적자 요인에다 2000년 관리체계의 통합과 동시에 시행된 의약분업과 수가인상으로 일시에 재정수요가 집중되면서 발생하게 되었다는데 대한 분석에는 별다른 이견이 없다. 다만, 각각의 제도 변화가 어느 정도 영향을 미쳤는지에 대한 견해 차이를 갖는 정도이다.

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