• Title/Summary/Keyword: 의료보험법

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의료보험법

  • The Korean Dental Association
    • The Journal of the Korean dental association
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    • v.9 no.7
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    • pp.451-457
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    • 1971
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The Constitutionality of Individual Mandate under the U.S. Patient Protection and Affordable Care Act of 2010 (미국 의료개혁법의 의료보험 의무가입 제도에 대한 연방대법원의 합헌결정)

  • Lee, Won Bok
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.275-302
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    • 2013
  • The Unites States has been plagued with soaring health care costs and an alarmingly large number of uninsured population. The Patient Protection and Affordable Care Act of 2010 ushered in the most sweeping health care reform in the United States since the introduction of Medicare and Medicaid in 1965 to address these issues. The law's requirement for individuals to purchase health insurance (the so-called "individual mandate"), however, not only caused a political stir but also prompted constitutional challenges. Some questioned whether the federal government, lacking general police power, could require its citizens to buy unwanted insurance based on its enumerated powers under the U.S. Constitution. This paper summarizes the decision of the U.S. Supreme Court on the constitutionality of individual mandate, and explores how the decision relates to Korea's own universal health care.

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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.

The Job Stress and Mental Health of the Insurance Reviewer (보험심사 근무직의 직무스트레스와 정신건강)

  • Kyoungjin Song;Jeongwon Lee
    • Journal of Service Research and Studies
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    • v.11 no.1
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    • pp.31-44
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    • 2021
  • The net function of the domestic medical insurance system is highly regarded, but due to the problem of incomplete coverage, the public wants to secure coverage through private medical insurance subscription. As a result, the subscription rate of private medical insurance has recently increased, and the billing rate has also increased. As the number of people seeking private medical insurance increased, workers at private medical insurance companies are experiencing increased job stress and side effects, especially for insurance reviewers who are in charge of paying insurance, such as communicating with customers who claimed insurance and contributing to the company's profit. In response, this study analyzed the effects of job stress on mental health of insurance reviewers and conducted a descriptive survey study to reduce job stress of insurance reviewers and promote mental health. The analysis shows that job stress for insurance reviewers has a significant impact on mental health (+). In detail, job stress has a significant impact on all four factors: social performance and self-confidence, depression, sleeping disturbance and anxiety, and general well-being and vitality. This study showed that job stress in insurance reviewers has a significant (+) impact on mental health. Job stress can cause side effects in organizational aspects, such as reducing enthusiasm for job performance and increasing turnover and resignation rates, but it can also worsen individual physical health and cause diseases such as depression and anxiety, causing mental health to be impoverished. Therefore, in order to prevent this, appropriate work stress prevention methods and countermeasures should be provided to help reduce work stress and improve mental health.

유럽의 화재보험 관계법령 소개

  • Lee, U-Lee
    • 방재와보험
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    • s.46
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    • pp.73-75
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    • 1990
  • 화재로 인한 인명 및 재산상의 손실을 예방하고 신속한 재해복구와 인명피해에 대한 적정한 보상을 하게 함으로써 국민생활의 안정에 기여하게 함을 목적으로 1973년 2월 6일 법률 제 2482호로 공포된 "화재로 인한 재해보상과 보험가입에 관한 법률"에 의거 서울특별시, 5개직할시 및 전주시에 소재한 특수건물(4층 이상건물, 국유건물, 교육시설, 백화점, 시장, 의료시설, 흥행장, 숙박업소, 송장, 송동주택 등) 소유자는 "신체손해배생 특약부 화재보험" 에 의무적으로 가입토록 되어있다. 이밖에도 국가저액적으로 또는 국민 복지증진을 위하여 많은 종류의 의무보험을 실시하고 있으며, 특히 위 법률과 유사한 사례로 국내에는 "항공운송 사업진흥법" (제7조), "산림법" (제113조)에 보험가입에 대한 의무규정이 있다. 일본 동경해상화재보험(주)에서 발간한 "손해보험과 시장"과 영국에서 발간한 "Handbook of risk management"에 의하면 거의 대부분의 국가에서 책임보험등 의무보험제도를 실시하고있으며, 특히 스위스, 서독, 벨기에, 아이슬란드, 브라질에서는 특수건물 화재보험과 유사하게 건물에 대한 의무보험제도를 실시하고 있는데 이들 국가중 스위스에서는 이미 180여년전부터 26개 주 중 19개 주에서 모든 건물에 대하여 화재보험 가입을 의무화하고 있으며, 그 수용동산까지도 화재보험에 부부토록 강제화되어 있는 주도 있다. 한편 서독에서도 오래전부터 건물의 화재보험 가입을 의무화하고 있는 주가 많으며, 의무화를 실히하고 있지 않은 주도 보험가입은 임의적이나 가입시에는 반드시 주가 지정한 공영건물보험기관에 가입토록 하는 독접형태로 운영되고 있다. 따라서 외국의 의무보험 실태를 보다 구체적으로 파악해 보기 위하여 스위스 바젤주(Basel- Stadt- Kantons)의 건물보험법을 소개하고자 한다.

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The Political Dynamics of Policy Networks and Advocacy Coalitions in South Korea's Healthcare Policymaking : The 20 Years of Debates to Inaugurate a Single-Payer System (한국에서의 의료보험조합 통합일원화 논의의 정치 : 정책 네트워크, 옹호연합, 그리고 보건의료 정책형성의 동태성)

  • Kim, Soon‐yang
    • Korean Journal of Social Welfare Studies
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    • v.42 no.4
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    • pp.61-102
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    • 2011
  • The purpose of this article is to anatomize the political dynamics of South Korea's healthcare policymaking through the integrative analytical framework combining the policy network perspective and the advocacy coalition theory. This framework is expected to be advantageous to the analysis of Korea's turbulent healthcare policy change from a systematic and process-driven point of view. A target of analysis is the two decades of turbulence to transform the health insurance system into a single payer system. Through the analysis, this article tries to illuminate the dynamics of Korea's healthcare policymaking, by connecting environmental context, policy networks, advocacy coalitions, and policy outputs. For a case study, this article classifies the debates to inaugurate a single payer system into four sub-phases and conducts longitudinal comparative research.

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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