• 보건행정학회지
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• 제14권2호
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• pp.17-33
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• 2004

The present study attempts to examine the progressivity of health care financial sources based on the income approach, for which it decomposes redistributive effects into vertical, horizontal, and re-ranking components. The study data include Korean Household Expenditure Survey (2000) conducted every 5 year by Korea National Statistical Office. The data were sampled from the national population by the multistage probabilistic sampling method, and amounts to 23,270 households. For the better application of the income approach, the study employs household total expenditure in Korea instead of total income, because the former data source is more reliable and less fluctuated over time. Progressivity of health care financing was measured by Kakwani index. Aronson's decomposition equation was used in case of the analysis where differential treatment of health care expenditure needs to be considered. Despite the progressivity of Korea's governmental contributions, total expenditure of health care showed regressive pattern, which may largely be attributable to the higher regressivity in out-of-pocket money. With the result of negative Kakwani index, differential treatment increased income redistribution biased for better-off. It is worth to note that social insurance displays not only negative Kakwani index, but also horizontal inequality, suggesting that the first step of health care financing reform should be the revision of social insurance premium rates toward effective and equable way.

• 사회복지연구
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• 제47권4호
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• pp.309-332
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• 2016

본 연구의 목적은 국민건강보험 지역가입자의 부담능력별로 수직적 형평성을 측정하고, 각 부담능력 및 인구학적 특성이 보험료의 변화와 인과관계를 보이는지 종단 분석하는 것이다. 분석대상은 한국복지패널 6차(2011년)-10차(2015년) 조사에 모두 참여한 지역가입자 가구주이다. 분석방법으로는 카크와니(Kakwani) 누적지수 산출 및 패널회귀분석을 적용하였다. 연구결과는 첫째, 2011년-2015년까지 카크와니 지수는 종합소득에 대한 보험료 부과가 역진적임을 나타내고 있다. 둘째, 패널회귀분석 결과 종합소득이 적은 가구일수록 보험료 부담이 통계상 유의미한 부(-)의 영향력을 보여 역진적임을 보였다. 이를 통해 국민건강보험 지역가입자의 보험료 부과체계 개편에 대한 정책적 함의를 제시하였다.