• Title/Summary/Keyword: Insurance benefit

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Changes and Challenges in the Concept of Industrial Accident Insurance in Korea (산업재해 인정 형태 변화와 보상체계 합리화 연구)

  • Kim, Jin-Soo;Ra, Ji-Hun;Lee, Seong-Young
    • Korean Journal of Social Welfare
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    • v.59 no.3
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    • pp.59-73
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    • 2007
  • The compensation system in industrial accident insurance is systemized with "either receiving all or no benefits at all" according to "admited or denied as an industrial accident". Therefore, they are centered on the decision as "industrial accident" or "non-industrial accident", but judging between the two is very complicated, and has inherent conflicting factors. In the early stage of industrialization, industrial accident compensation was based on the indemnity liability for employer's faults. In order to be compensated any damage, the injured worker should prove that the accident was not due to his or her faults. However it was very difficult for injured worker or his or her family to prove the employer's faults, so it was almost impossible to get compensation. Thereafter industrialization progress and improvement of workers' political status lead to conversion from principle of liability with employer's faults to principle of liability without employer's faults. In addition to that, coverage of industrial accident compensation was also expanded. This improvement strengthened the benefit payment principle of "All or Nothing". Even though the "All or Nothing" principle provokes tremendous criticism, the reason why it's difficult for industrialized countries to adopt partial compensation system, is that partial compensation system worsens the administrative hardship, therefore industrialized countries overcome the restrictions of the "All or Nothing" principle with making balance in provisions for any risk to some extent. However, in Korea because the general compensation system for covering medical cost and income loss from accidents, is not equipped, it could be possible to cause acute conflicts with regard to coverage of industrial accidents. Therefore it is required to improve the industrial accident insurance with the acceptance of the significance and logic of discriminated compensation, and create the integrated compensation system in the long run.

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Current Status of MRI Distribution, Prevailing Charges and Analysis of Its Performance (MRI 분포와 관행수가 현황 및 촬영실적 분석)

  • 문옥륜;장원기;이상이;김철웅;최경혜
    • Health Policy and Management
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    • v.8 no.1
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    • pp.155-182
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    • 1998
  • There exists a remarkable differences in use of MRI scanning among income classes. The poor can hardly utilize it. This is because, among high cost technnologies, MRI is the only equipment not covered under health insurance benefits in Korea. This study was designed 1) to reveal the status of nation-wide MRI installation, customary charges and per unit annual scanning performance, and 2) to analyse factors influencing the above variables. The data for this study came from "MRI Prevalence Survey" conducted by the National Federation of Medcial Insurance(NFMI) in 1997, and were analyzed through SAS packages for T-test, analysis of variance and stepwise multiple regression. Data were collected from 188 hospitals equipped with MRI scanners. Major findings are summarized as follows : The number of MRI scanners has increased from 69 in 994 to 158 in 1996(2.3 times) while per unit annual scanning performance has risen by 11.2% from 2,173 cases in 1994 to 2,417 cases in 1996. Such a rapid increase was made possible mainly due to the inclusion of CT scanning under the health insurance benefit package. The customary charges for MRI scanning with or without contrast media, on average, amounted to 484,000 Won and 402,000 Won, respectively, with the percentile increase of 17.8% and 8.1% each during the same time. Korea ranks the third worldwidely in terms of number of MRI installations, 4.8 scanners per one million persons, only next to Japan and United States. Geographical variation of MRI, however, was rather high, 7.91 unit, in Cheju area compared to 1.82 in Kyongnam area. Variations of customary charges of MRI scanning can be explained as much as by 44.8% by both the total amount of claims to NFMI and geographical variable. The charges were more likely to be higher in metropolitan areas like Seoul and in hospitals with a bigger amount of claims. While those of per unit annual scanning performance can be explained as much as by 30.7% by both MRI installation cost and level of MRI-installed organizations. Per capital scannig performance was higher in tertiary hospitals and hospitals equipped with more expensive scanners than hospitals with less expensive scanners. Two measures are called for the remedying the existing excessive abundance in MRI units in korea : One is to set a ceiling of MRI units in an area like a province or a metropolitan district. The other is to establish a committee on introduction of high cost technologies for reviewing its effective use.ctive use.

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Improvement Devices on the Law and Institution and Current Situation of Health and Medical Treatment for the Aged (노인보건의료의 현황과 법 제도적 개선방안)

  • Noh, Jae-Chul;Ko, Zoon-Ki
    • 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.

A Study on the Improvement Approaches of Immigration Workers' Legal System to Introduce Foreign Workers according to change the Population Structure (Low Fertility and Aging) (인구구조 변화(저출산·고령화)에서 외국인력 도입을 위한 이주노동자의 법제도적 개선방안 연구)

  • Lee, Chuck-He;Noh, Jae-Chul
    • Industry Promotion Research
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    • v.6 no.1
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    • pp.79-86
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    • 2021
  • Due to the change in the demographic structure, the problem of low birth rate and aging population leads to a serious decrease in human resources, and the necessity of introducing foreign workers is increasing. This study believes that the introduction of foreign workforce is the most effective to expand the working-age population in the era of low birthrate and aging, when demographic changes begin in earnest, and to this end, it sought to devise measures to improve the legal system for migrant workers. As a result of this study, first, the legal system for migrant workers should be unified and improved. It is necessary to establish or unify management agencies so that the 「Immigration Control Act」 and the 「Labor Act」 can establish a cooperative relationship. Second, the 「Immigration Control Act」 should be revised to make it easier for migrant workers to find employment. It is necessary to positively review the employment permit system and acquisition of nationality. Third, there should be no equity or discrimination against migrant workers. Under the principle of mutual benefit, employers and migrant workers should not be equally discriminated against. Fourth, the social insurance system must be added to the legal system of migrant workers. Therefore, the legal system should be reorganized so that migrant workers are not discriminated against in various insurance systems including the four major social insurance systems. In conclusion, the problem of low birthrate and aging population has become a serious social problem due to changes in the demographic structure, and the decrease in the possible generation population has reached a level of concern. The importance of migrant workers' employment and work environment is increasing. Nevertheless, related legal and institutional problems still exist, and measures to improve the legal system for migrant workers are needed.

Review of Allowable Condition of the Discretionary not Covered Service (임의비급여 허용요건에 관한 검토)

  • Park, Tae-Shin
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.11-38
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    • 2012
  • The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

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An economic feasibility analysis of the reduction of accident at fishing operation in stow net fishery (안강망어업 작업 중 안전사고 저감의 경제적 효과 분석)

  • KIM, Do-Hoon;YI, Ju-Hyun;LEE, Yoo-Won
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.56 no.3
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    • pp.258-264
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    • 2020
  • This study aimed to analyze the economic feasibility of the reduction of working safety accidents in stow net fishery through the prevention education to fishing crews. The benefit was evaluated by estimating insurance payment amount that was reduced through prevention education. The decreasing rate of working safety accidents was presumed to follow the experience in Japan. The cost was assumed as the cost of textbook development. Results indicated that IRR was estimated to be 79.9% in case of scenario assuming no additional operating costs while IRR was 56.3% in case of scenario assuming 10% additional operating costs. In addition, the economic feasibility would be secured when annual operating costs increased to 274 million won according to the result of sensitivity analysis.

Effects of Youth Unemployment Bonus (청년고용촉진장려금 효과 분석)

  • Lee, Chul-In
    • Journal of Labour Economics
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    • v.39 no.4
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    • pp.1-29
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    • 2016
  • This study examines the effects of the "youth unemployment bonus" program implemented in 2004. We view this program through the lenz of search-matching models and apply a quasi-experimental approach to an administrative unemployment insurance database of Korea. This episode is particularly useful because the program aims at long-term unemployed youths and the size of public assistance is large enough to subsidize employers for a year with a monthly subsidy of about $600. The main effects are found to be as follows: (i) the search period gets shortened by 18 days, (ii) the subsequent wage has increased by about three percents, and (iii) a conservative benefit-cost analysis reveals the validity of this program. We interpret these results in the context of general equilibrium models.

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The Effects of Fertility Policies on Childbirth by Birth Order (저출산 대응정책이 출산순위별 출산에 미치는 영향)

  • Yoo, Gye-Sook
    • Journal of Families and Better Life
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    • v.27 no.2
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    • pp.191-201
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    • 2009
  • The Korean Government has recently prepared the comprehensive five-year basic plan (2006-2010) to deal with low fertility and population ageing. The basic plan aims at recovering the fertility rate to the appropriate level and improving the social and economic systems in preparation for the aged society. The main objective of this study was to examine the effects of fertility policies on childbirth by birth order. The data came from 1,729 adults who gave birth to babies in 2007 and 991 adults as the control group. The serial logistic regression analyses revealed that establishing the health and nutrition system for maternity and children, and expanding of tax and social insurance benefit were effective policy measures to increase childbirths of first children, while the policy measures establishing the health and nutrition system for maternity and children, supporting for daycare and pre-school education, and work-life balance were effective to childbirths of second or third children in 2007. However, the policies of supporting for costs of test-tube baby and expanding childcare infra didn't have any significant influences on childbirths in 2007. The implications of study results were discussed.

Predictors of Human Papillomavirus Vaccination in Female University Students (여대생의 인유두종바이러스 예방접종 예측요인)

  • Park, Jeong-Sook;Lee, Eun-Joo
    • Women's Health Nursing
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    • v.17 no.4
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    • pp.346-358
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    • 2011
  • Purpose: The purpose of this study was to identify predictors of HPV (Human papillomavirus) vaccination among female university students. Methods: The participants in this study were 1,486 female university students. Data were collected using self-administered questionnaire from september 1, 2010 to June 30, 2011. Data were analysed using descriptive statistics, t-test, $x^2$-test and logistic regression. Results: The rate of HPV vaccination was 7.2%. Factors that influence HPV vaccination included residential region, smoking experience, family history of cervical cancer, experience having heard about the HPV vaccination, awareness that HPV is a sexual disease, HPV knowledge, perceived seriousness, perceived benefit and perceived barrier in health beliefs. Conclusion: The results suggest a need to increase HPV vaccination campaigns to increase awareness of HPV vaccination. University and health care facilities should provide health education emphasizing perceived seriousness and perceived benefits. Also, the national health insurance corporation should consider addressing cost issues as a barrier to HPV vaccination.

A Study on the Validity of the Deviation Clause of B/L in the Contract for the Carriage of Goods by Sea (해상운송계약(海上運送契約)에서 선화증권(船貨證券) 이로조항(離路條項)의 유효성(有效性)에 관한 고찰(考察))

  • Kang, Byeong-Chang;Jo, Jong-Ju
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.18
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    • pp.137-157
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    • 2002
  • The clauses of bill of lading(B/L) consist of the terms of contract for the carriage of goods by sea because of clauses of B/L by the mutual agreement of contracting parties. There are some exempted cause of deviation clause in B/L for specific reasons. Then deviation clauses are influenced by Rules of international carriage of goods by sea, because the international rules become the governing law of contract for the carriage of goods by sea. The problem of deviation clauses in B/L is stipulated as follows. "It shall be prerequisite to the Merchant' claim for damages on account of deviation that the merchant's insurance shall first have been cancelled on account of alleged deviation. No deviation shall oust the right to limit liability or damages, and the Carrier shall always be entitled to the full benefit of all privileges, rights and immunities contained in this Bill of Lading and incorporated tariffs." This stipulation should be adjusted according to the confirmed cases, otherwise it will be invalid according to the Hague Rules and Hamburg rules. The sphere of a reasonable deviation in the deviation clause should be interpreted in the connection with the designed voyage and the commercial object of contract for the carriage of goods by sea and the deviation become valid unless the policy, the general object of international rules or the true intention of contracting parties has violated.

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