• 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.

• Journal of the Korea Society of Computer and Information
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• v.19 no.5
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• pp.109-117
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• 2014

This study tries to find the policy instruments that have used in the process of social insurance policy implementation. The results can be summarized as follows: First, in case of compulsory policy instrument, the government uses the regulation, public enterprise and government insurance in the process of implementing of all the social insurance policy. Second, in the case of mixed policy instrument, the government use the user' contribution in the process of implementing of all the social insurance policy but the subsidy was used in the process of implementing of the medical, pension, unemployment and long-term care insurance for the aged policy. Also, the information and discipline was used in the process of implementing of unemployment insurance policy and the partnership was used in the process of implementing of long-term care insurance for the aged policy. Third, in case of voluntary policy instrument, the government uses the family and community in the process of implementing of almost the whole social insurance policy.

• 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.

• Journal of the Korean hospital association
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• v.31 no.3 s.277
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• pp.14-19
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• 2002

우리 국민의 의료서비스에 대한 불만은 매우 높다. 더더욱 최근 건강보험의 통합과 관련한 정치권과 행정부의 정책혼선과 의약분업 정책에 의해 야기된 불안과 불만은 정권자체의 불신을 초래하는 단계에까지 이르고 있다. 혼선과 불만이 야기된 근본적 원인은 정책담당자들의 무지, 일부 학자들의 잘못된 이념적 선동, 그리고 일반국민의 허황된 기대에서 찾아진다. 이 과정에서 얻는 중요한 교훈은 어떠한 정책이든 뜨거운 가슴으로 되지 않으며 무엇보다도 냉철한 머리가 정책의 중심을 차지하여야 한다는 것이다.

• The Monthly Diabetes
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• s.256
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• pp.68-69
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• 2011

`건강'에 대한 의미가 특별해지는 요즘이다. 남녀노소를 불문하고 다양한 질병에 노출되어 있는 시대이니 만큼 정부에서도 촉각을 곤두세우고 의료 환경 개선에 적극 나서고 있다. 이에 따라 지난해에 이어 올해도 보험급여 확대를 통한 건강보험보장성을 강화하고 취약계층에 대한 다양한 의료혜택 제공 등의 정책이 추진된다. 2011년 바뀌는 보건의료제도를 알아보자.

• Korean Journal of Social Welfare Studies
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• v.47 no.4
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• pp.309-332
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• 2016

This research attempts to calculate the vertical equity of National Health Insurance Contribution of locally provided policy holders by abilities to pay. Also, this longitudinal study examined the influence of abilities to pay and demographic characteristics on the health insurance premium. Using data from the Korea Welfare Panel Study, this study followed the self-employed households who continued to participate in the survey from 2011 to 2015. Kakwani's index of progressivity was measured as a measure of vertical equity and panel regression analysis was conducted by STATA program. The results of this research are as follows. First, from 2011 to 2015, the values of kakwani's index were negative according to composite income, which meant some levels of regressiveness of contribution. Secondly, panel regression analysis showed that the lowest household of composite income had a significantly negative effect on premiums, which also meant regressiveness. Based on the results, the author suggested political discussions on reorganizing the system of imposing the National Health Insurance contribution.

• Korean Journal of Social Welfare Studies
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• v.41 no.2
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• pp.35-65
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• 2010

The purpose of this study is to identify the relationship between health insurance and health by evaluating the impacts of health insurance coverage expansion on health care utilization and health status. To analyze the causal relationship between health insurance and health, this study employed a "difference-in-difference method" that could compare changes in health care utilization and health status across groups in health insurance coverage expansion in 2005. The researcher predicted that the expansion of health insurance coverage would be an exogenous source of variation in the prices of health service use. First, the difference-in-differences estimator between 'illness group' and 'non-illness group' revealed that the increase in coverage of inpatient care services would result from the increases in the stay of length of 'non-illness group' rather than that of 'illness group'. However, the difference-in-differences estimator between 'serious illness group' and 'chronic illness group' identified that the policy change that focuses on expansion of the coverage for 'serious illness' effects on the increases in health care utilization and promotion of health status. In summary, the changes of health insurance coverage focusing on serious illness and inpatient care have positive effects on health care utilization and health status of serious illness group. But, 'non-illness groups' with acute illness receive more benefits from the policy change than 'illness group' with chronic illness.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• 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.

• The Korean Journal of Applied Statistics
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• v.31 no.6
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• pp.693-706
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• 2018

It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.