• 한국사회복지학
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• 제40권
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• pp.68-96
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• 2000

Parental leave in Sweden is a part of the health insurance in national social insurance system. It has two kinds of benefits. One is parental cash benefit paid for both husband and wife on the occasion of child birth, currently 450days for each child. The other is temporary parental cash benefit when a child under the age of twelve or a caretaker for him is illness, which is six months for a child a year. Parental insurance in Sweden permits parents to take care of their children just after birth at home with the amount of 80% of monthly income for 360 days and 60 Swedish krone each day for 90 days more. It also permits parents with children under the age of eight of part-time work and return to former job at full-time base when they want. It consequently encourages women's economic activity in her whole life and contributes to promotion of equality in sex roles between husband and wife. This insurance scheme is beneficient in that it enhances individual and family welfare and also secures labour force. This case study on Swedish parental insurance offers implication how to resolve the conflict between women's increased demand for economic activity and maternal role.

• 보건행정학회지
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• 제27권2호
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• pp.103-113
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• 2017

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

• 보건행정학회지
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• 제19권3호
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• pp.142-165
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• 2009

Although providing universal coverage for health care through the National Health Insurance(NHI) is a remarkable achievement, the issue of limited benefit coverage of the NHI has been at the core of national debate over how to improve its coverage. This study aims to evaluate benefit extension strategies and implemented policies with regard to the NHI since 1989 using 'policy window theory' proposed by John W. Kingdon. Understanding problem stream, policy stream, political stream, and coupling streams regarding the NHI, in particular benefit extension, would contribute to broaden policy debates and to develop more effective strategies for the future. Historically, political stream had opened policy window in the past two decades and policy streams can be characterized by three waves. Three streams have been coupled since 2003 and the government had a strong will to fulfill better performance of NHI coverage. Study findings indicate that identification of problem structure regarding NHI benefit was not connected with policy stream tightly. In addition, there has been limited discussion on policy goal and principles for extension coverage of the NHI. Policy strategies to improve coverage of the NHI should be linked to characteristics of problem and sought solutions under the principle which is expected to be sustainable through consensus in the society.

• 한국임상약학회지
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• 제30권3호
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• pp.177-184
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• 2020

Background & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion: This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

• 한국콘텐츠학회논문지
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• 제11권4호
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• pp.263-272
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• 2011

본 연구는 국내외 문헌고찰을 통하여 건강보험과 산재보험, 자동차보험을 중심으로 선진국의 국민의료비 관리제도를 살펴보고, 우리나라 국민의료비 관리제도의 문제점을 파악하여 올바른 국민의료비 관리방안을 제안하는데 목적이 있다. 분석결과 첫째, 선진국의 경우 국민의료비를 단일기관에서 통합해 운영하면서, 동일한 수가와 급여기준을 가지고 운영하고 있었다. 즉, 의료비 발생원인에 관계없이 동일한 기관에서 동일한 기준으로 통합관리하고 있었다. 둘째, 우리나라의 경우 국민의료비를 보험제도별로 다른 기관에서 분리운영하면서, 서로 다른 의료비 심사·평가, 수가를 적용하고 있었다. 이로 인해 동일증상과 상병임에도 불구하고 관리주체에 따라 의료이용량의 차이가 매우 컸다. 이러한 문제를 근본적으로 해결하기 위해서는 의료비발생의 원인이 무엇이든지 하나의 기관에서 동일한 수가체계와 기준에 근거해 통합관리해야 한다.

• 보험의학회지
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• 제2권1호
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• pp.3-16
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• 1985

Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

• 보건행정학회지
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• 제15권3호
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• pp.17-39
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• 2005

Social solidarity, equity in financing, and efficiency in administration have been core issues in the development of Korean health insurance reformation since 1988. This study is to investigate the trend of administrative cost in Korean National Health Insurance from various aspects. For the analysis of administrative cost, the expenditures of each insurance society and the National Health Insurance Corporation are divided into 4 items of (1) insurance benefit, (2) administrative cost, (3) an agency provision accounts, (4) other expenses, and then they are reorganized. The analyses based on 5 types of the health insurance administrative cost showed that efficiency in administration has been improved generally. We, however, should consider qualitative aspects such as customer's satisfaction with health insurance administration, prompt service, control of unjust expenditure (unjust claims), and provision of medical service including health consultation in assessing efficiency of administration. And, in order to connect the administrative costs of health insurance with efficiency, we need to give a fundamentally new definition, which can contain elaborateness of expenditure in details including the structure and evaluation method of administrative costs. It may be necessary to develop new indicators or analyzing methods hereafter.

• 보건교육건강증진학회지
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• 제29권5호
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• pp.37-48
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• 2012

Objectives: The economic evaluation of health promotion programs has increasingly become an imperative activity for securing public fund or budget. The purpose of this study is to conduct an economic evaluation for the healthy school canteen program using the contingent valuation method(CVM). Methods: To estimate the benefit from the healthy school canteen program, double-bounded dichotomous choice method as a sort of willingness to pay was employed. Four hundred parents who lived in Seoul and have students at middle or high schools, were administrated by semi-constructive questionnaire containing the necessary information for benefit estimation. Cost estimation of healthy school canteen program was made referring to three types of pilot programs. Finally, the benefit against the cost was worked out according to the three levels of estimated cost. Results: Cost estimate is 8,488 and 9,311 won depending on the two senarios about how to invest on the program, respectably. The results of benefit estimate shows that the average cost willingness to pay(WTP) for healthy school canteen program is 21,275 won(16,963-59,838 won, 95% CI) and total benefits turned out 14.7 billion won. According to the cost-benefit analysis, average benefit-cost ratio is from 2.3 to 3.6. Conclusions: Healthy school canteen program could be economically accepted, and government can take consideration of expanding beneficiaries of healthy school canteen program for health promotion.

• 보건행정학회지
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• 제29권2호
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• pp.112-129
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• 2019

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.

• 한국항공운항학회지
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• 제22권1호
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• pp.65-75
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• 2014

While traditional benefit plan offers the same benefits to employees regardless of their needs, cafeteria benefit plan or flexible benefit plan allows staff to choose from a variety of benefits to formulate a plan that best suits their needs. Cafeteria plan options may include health and accident insurance, cash benefits, tax advantages and/or retirement plan contributions. In this paper, we analyzed conditions and problems of domestic firms' current benefit plans and draw a resolution by introducing cafeteria plan by investigating related previous studies, Specially we focused on A airline which is typical service firm and is regarded as one that benefit plan can be very influential to employees compared to other firms.