• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.51-51
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• 2003

국민건강보험재정건전화특별법 (제정 2002.1.19 법률 제 6620호)은 건강보험의 재정적자를 조기에 해소하고 재정수지의 균형을 이루도록 함으로써 건강보험제도의 발전과 국민건강 증진 도모를 그 목적으로 하며, 제14조(특수의료장비의 설치ㆍ운영)에서 의료기관은 보건복지부장관이 고시한 특수의료장비를 설치ㆍ운영하고자 하는 때에는 보건복지부령이 정하는 바에 따라 이를 등록하여야 하며 설치 인정 기준에 적합하게 설치ㆍ운영하여야 하고 정기적인 품질관리를 받아야한다고 명시하였다. 특수 의료장비의 설치 및 운영에 관한 규칙 (제정 2003.1.14 보건복지부령 제235호)은 국민건강보험재정건전화특별법이 제정됨에 따라 특수의료장비의 적정 한 설치와 활용을 위하여 의료기관에서 설치ㆍ운영하는 특수의료장비의 등록절차 설치인정기준 및 품질관리 절차 등을 정하고 특수의료장비에 대한 관리체계를 확립하려는 것이다. 특수의료장비의 설치 및 운영에 관한 규칙의 주요 골자는 가. 의료기관에서 특수장비를 설치ㆍ운영하고자 하는 경우 보건복지부장관 또는 시ㆍ도 지사에게 등록하도록 하였는바, 이 등록에 대한 절차와 특수의료장비의 설치인정기준을 정함, 나. 특수의료 장비에 대한 정기적인 품질관리검사를 서류검사와 정밀감사로 구분하여 서류검사는 1 년마다, 정밀검사는 3 년마다 받도록 함, 다. 품질관리검사기관의 장은 특수의료장비품질관리검사성적서를 신청인에게 교부하고, 보건복지부 또는 시ㆍ도지사 및 건강보험심사평가위원장에게 검사결과를 통보하도록 함, 라. 특수의료정비를 설치ㆍ운영하는 의료기관의 개설자 또는 관리자 및 품질관리검사기관의 장이 작성ㆍ비치ㆍ보존하여야할 서류를 정함이다. 보건복지부장관에게 등록하여야할 특수의료장비는 자기공명영상촬영장치와 전산화단층촬영 장치이며, 시ㆍ도지사에게 등록하여야할 특수의료장비는 유방촬영용장치이다. 본 발표에서는 특수의료장비의 설치 및 운영에 관한 규칙에 대한 개요와 연세의료원 세브란스병원에서 시행하고 있는 특수의료장비의 정도관리 검사, 팬텀영상검사, 그리고 임상영상검사를 소개하고자한다.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.421-450
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• 2013

One of the challenging tasks of the National Health Insurance Corporation(NHIC). the only public insurance institution administrating the Korea's compulsory national health insurance(NHI) system, is to make those NHI beneficiaries who fail to make a scheduled monthly premium payment to pay. For this purpose, the NHIC has been using a measure known as 'Benefit Limit Measure(BLM)' in which those who miss premium payment for six or more month's in total are classified as 'late payer' and are sent warnings and late payer status notices. If the late payers fail to make a full payment of missed premiums even after receiving the written notices, the NHIC can order a temporary seizure of the late payer's property until all missed premiums plus interest are paid. Recently, the BLM has been criticized by the public of its cruel nature, and its effectiveness has been questioned because no empirical evidence has been collected. In this study, the authors using the NHIC data set attempted to analyze the effectiveness of the BLM. Those late payers for whom the BLM was administered were compared to those not in terms of the likelihood of paying missed premium payments with a series of logistic regression analyses models. Data analyses results showed that the likelihood of paying one or more month's unpaid premium of the former group was 14 to 46 times higher than the latter. It, however, was also found that the BLM was only effective to make no more than 12% of the late payers to pay at all. Based on the study findings, the authors made a few recommendations regarding the BLM.

• 한국사회정책
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• v.24 no.2
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• pp.31-60
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• 2017

This paper aims to reveal the background and issues of the current reform proposals for social insurance in Germany and to draw their implications for Korea. The essence of the German social insurance crisis is that of normality of industrial society on which it has been based, revealing itself by the dual crisis of finance and dualization. Reform proposals are regarded as diverse responses to the crisis of the normality within individual social insurance schemes. They are searching for transforming health insurance into citizen's insurance, pension insurance into various alternatives including all worker's insurance and citizen's pension, unemployment insurance into employment insurance. One of the commonalities of the them is that they attempt to reconstruct the old normality. However, due to the economic recovery, the historical experiences of improving social insurance, and high satisfaction, they are expected to struggle with the gradual improvements rather than radical shift from their tradition. In Korea, where the maturity of social insurance is low, it is necessary to mark the crisis faced by German social insurance as a teacher. We need to go back to the fundamental spirit of social policy and redraw the blue prints of social policy by opening minds to plentiful alternatives in the eyes of normality reconstruction.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

• 건강소식
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• v.24 no.2 s.255
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• pp.2-7
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• 2000

차흥봉 보건복지부장관의 좌우명은 '열심히 살기'다. 쉽고도 어려운 말이지만, 차 장관은 말 그대로 어떤 일이든 긍정적으로 생각하고 적극적으로 추진하는 자세를 잃지 않는다. 지난해 8월, 그가 보건복지부장관으로 임명되었을 때, 의료보험 통합ㆍ전국민 연금제도ㆍ의약분업 등 굵직하고 복잡한 문제들이 산적해 있었다. 하루도 거르지 않고 언론ㆍ시민 단체 등에서 시시비비를 논하는 상황이었지만, 차 장관은 모든 일을 국민의 입장에서 합리적으로 생각하고 소신 있게 업무를 처리해 대부분의 일을 정상퀘도에 올려놓았다는 평을 받고 있다. 새천년에는 모든 국민이 공평하게 건강과 복지를 누릴 수 있는 시대를 만들어 가겠다는 꿈을 '새천년 복지 비전 2010'으로 구체화된 차흥봉 장관으로부터 새해의 복지 정책에 관해 들어 본다.

• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3534-3547
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• 2014

Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.

• Journal of Family Resource Management and Policy Review
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• v.27 no.3
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• pp.39-52
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• 2023

In this study, based on survey data from Japan, I analyzed the differences between the expectations for social security and the perception of life in old age by age group. The analysis data used in this study are from the "Survey on Life Security, 2019" conducted by the Japan Life Insurance Cultural Center, which surveyed men and women aged 18 to 69. The results of the analysis are as follows. First, expectations about health insurance are higher than expectations about other forms of social security in all age groups. Second, when it comes to expectations for public pensions, both men and women have the highest average scores in their 60s. Third, the age group with the lowest average score for public health insurance, public pension, public care insurance, and survivors' pension was found to be those in their 40s. In addition, men in their 20s had a higher average score on their perception of life in old age. Fourth, the effect of social security expectations on perception of life in old age was found to be somewhat different for gender and age groups, but overall, it was found that public health insurance expectations were an important factor that had a positive impact on the perception of life in old age.

• 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.

• 한국호스피스완화의료학회:학술대회논문집
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• 2008.07a
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• pp.22-26
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• 2008

호스피스-완화의료 사업에 대한 정부 차원의 지원이 점점 가시화되고 있다. 사업지원금을 제공하는 것과 함께 건강보험수가에 반영하기 위한 작업이 속속 진행되고 있으며, 이와 관련된 법률의 정비에 대해서도 관심이 높다. 이같은 의료제도의 변화 속에 호스피스 사업이 제대로 자리를 잡아가기를 기원하면서, 현재 논의되고 있는 사안에 대한 검토와 함께, 향후 부딪히게 될 문제점에 대하여 정리해 보고자 한다.