• 의료법학
• /
• 제8권2호
• /
• pp.9-35
• /
• 2007

The Health care program in Korea has now been systemized after 30 years of declaring the inauguration of the national health insurance system by the current government. The national health care covering all Korean citizens was achieved after 12 years of implementing the national health insurance and the health care program since 1977. Hundreds of multiple operational agencies managing the insured individually had undergone the amalgamation process from 1998 to 2000, and had been restructured as one agency, the National Health Insurance Corporation. In 2003, the community/area based financial management was also merged together with the employment based financial management. The National health care system of Korea offer various merits, compared with that of other countries, such as health care provision covering all Koreans, low insurance premium, accessibility of medical services/facilities etc. However, there are still some weak features which need to be addressed for improvement; below expectation insurance cover system, mistrust on the medical services, low medical charges resulted from excessive restrictions, and unstable financial status of the national health insurance etc. Therefore, the National health care system should continue to evolve to re-establish itself as more effective national health care system by further strengthening its merits, and by improving its weaknesses; with adopting the positive system to optimize the costs of prescribed medicines/drugs, applying simpler insurance coverage system to calculate the optimum medical charges, promoting private medical insurances, and increasing insurance premium etc.

• 의료법학
• /
• 제8권2호
• /
• pp.37-68
• /
• 2007

Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

• 보건행정학회지
• /
• 제8권1호
• /
• pp.135-154
• /
• 1998

In Korea, the institutional reform for the national medical insurance system is in process. Eventually, three kinds of the national medical insurance system, i.e., medical insurance program for the industrial workers, the govemment employees and the private school teachers, and the self-employeds, would be merged into an unifed system. In this study, I analyzed the annual trends of the finance in the medical insurance system in Korea, in which I found the financial instability especially in the medical insurance program for the self-employeds. The regression analysis was carried out to forecast the accumulated reserve at the end of this year for the medical insurance program for the self-employeds. I also analyzed the economic effect of the merge of the medical insurance program for the self-employeds by using the case of Japan and Korea. I found that the medical insurance for the self-employeds is expected to have financial deficit at the end of the year 1998 after the merge. In onclusion, it seems to be quite difficult to solve the financial instability in the medical insurance program for the self-employeds after it would be merged. That means that there would be a lot of problems on the way to the merge.

• 대한건축학회논문집:구조계
• /
• 제35권1호
• /
• pp.29-36
• /
• 2019

In the past, social insurance premiums, such as national pension and national health insurance, is contained within the costs of construction projects, have been lowered due to price competition of companies participating in the bidding. The government is implementing the "Ex-post settlement system" to improve the problem. Therefore, the purpose of this study is to examine the concept of an Ex-post settlement system and background of its introduction and to identify problems in the management of the system. The problems of the Ex-post settlement system are: 1) avoiding the participation of construction workers, 2) the rigidity of the insurance premium settlement method in construction field, and 3) the cause of direct construction cost reduction. The ways to improve these problems are: 1) excluding social insurance premiums from construction project cost, 2) securing flexibility of the settlement method of insurance premiums in construction field, and 3) expanding the scope of persons eligible to participate in social insurance.

• 대한예방한의학회지
• /
• 제1권1호
• /
• pp.137-148
• /
• 1997

The Serial Securities and the Social Welfare, as the national policy aimed at securing generals' lives, are the policies or systems for the stabilization in lift; especially of law-incomers and workers, for which the povernment has to establish the Social Security System. No wonder the Social Insurance System is a part of the Social Security System and the most important. The Social Insurance System, along with Public Assistance, is underlying the Social Security System. Social Security System includes medical insurance, industrial accident Compensation insurance, national pention insurance and employment insurance. The study is on 'The Oriental Medical Insurance and the Industrial Accident Compensation in the Social Security System' . The rate of industrial accident in Korea marks the highest rank in the world. for laborer, industrial accident do not merely mean the loss of health but the question of the right to live in terms of their loss of opportunity of life. The industrial accident compensation system should be established as the es post facto remedy system to guarantee the injured worker and his/her family's life. The oriental medical insurance system which began to operate in 1987 in Korea is based on unionism and divided into 3 parts; one part for the worker, a second part for the community inhabitants, and a third part for the public service personnel and private school personnel. Today the medical problem must be the most important social assignment to be considered. The medical system of contemporary industrial society has began greatly stood out in relief as a part of social welfare not emphasized on gainings of physicians. Accordingly systematization of the oriental medical insurance was strongly Pursued and it was developed to to the extent of entire nation insurance. Though the history of it is very short, most of the people are getting benefit from the insurance system by the social security system method. This study develops the Oriental Medical Insurance, the Workmen's Accident Compensation Insurance, the Pension System in relation to the industrial accident compensation of Employees, along with the ideas and principles of social insurance.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.161-175
• /
• 2005

Since the introduction of mandatory health insurance in In, the Korean national health insurance(KNHI) has grown rapidly. In 2004, about $96.9\%$ of the total population are covered by the KNHI and the remaining $3.1\%$ by the Medical Aid program. Despite national health insurance system in Korea, private health insurance market has grown rapidly. In 2004, the size of the private health insurance market was estimated at 6,568 billion won. The purpose of this study Is to identify the factors that determine the purchasing decisions of supplementary private health insurance under mandatory national health insurance system in Korea. The data from n04 Busan Health Survey were analysed for the Purpose. The variables in this study are demographic factors, health status and health behavioral factors, health care systemic factors, and socioeconomic factors. For statistical analyse, we used logistic regression. The Findings show that female, economically active age group(especially 35-49 years), persons with better health status or experience of health screening test are more likely to purchase private health insurance. And higher household income and expenditure, higher education level are more associated with the increased probabilities of private health insurance purchases. This results imply that the expanding of private health insurance market could widen the gap between the have and have-not in terms of equal health care accessibility.

• 의료법학
• /
• 제8권2호
• /
• pp.69-118
• /
• 2007

In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.

• 무역학회지
• /
• 제45권3호
• /
• pp.133-146
• /
• 2020

In the UK's the insurance law 2015, a remedy for breach of warranty in marine insurance was introduced. Also, if the insured proves that breach of warranty in marine insurance does not affect damages, the insurer pays the insurance money to the insured. The UK's marine insurance law has served as the governing law that has been the standard for the marine insurance industry for a long time. Korea and China were heavily influenced by the UK maritime insurance law. Therefore, this study analyzed the cases of breach of warranty in marine insurance in Korea and China. Through this, the insurer avoid the insurance contract for an accident that occurred after the breach of warranty. this result will be different under the new revised insurance law system. With the revision to The Insurance Act 2015, one of the biggest change in the insurance system is that it is possible to remedy of the violations of warranty. However, such a revision of the law requires considerable attention as it also changes the interpretation and judgment of the courts. Accordingly, a practical response of the insurance industry is required. It is necessary to prepare for possible disputes in practice.

• 보건행정학회지
• /
• 제28권3호
• /
• pp.210-216
• /
• 2018

National Health Insurance Service (NHIS) has put a great effort on extending life expectancy, for last 40 years. The system has also made remarkable outcomes in achieving universal health coverage. However, it is facing challenges of low health insurance benefits and sustainability risk due to low birth rate and aging society at the same time. To overcome the difficulties and build a lifelong health security system for the nation, it is required for NHIS to make multilateral changes in its roles. Based on the quantitative growth achieved so far, NHIS needs to strive for the growth in quality by not only increasing coverage and reforming contribution imposition system, but also reorganizing the relevant systems such as lifelong health management support, rational adjustment to the medical fee, and benefit costs monitoring. In addition, it's important for NHIS to restructure the organizational culture by having specialty and communicating with people for high quality of administration and health insurance sustainability.

• 보건행정학회지
• /
• 제10권1호
• /
• pp.57-94
• /
• 2000

Korea's social health insurance system was introduced in 1977, which has made a universal coverage possibly by July 1989. Korean government had pursued a single objective for the last decade to put the whole population under the coverage of medical security, and the objective was achieved within 12 years. The rapid accomplishment is primarily due to such factors as limited benefits, high copayment rate, low contributions as well as rapid economic growth. There are several sources of pressure for the implementation of social health insurance such as health professional group, labor unions, politicians, international organizations etc.. However it is important to look at the feasibility of social health insurance. Among other things, it is necessary to identify the administrative infrastructure of insurance system and to assess income for source of fund. As many developed countries, Korea began to apply health insurance to the employees of the large firms, and the expansion based on employment status. Thus the several funds system was inevitable according to the gradual expansion strategy. However many persons had criticized several funds system in respect with equity and efficiency aspects. In the short history of the Korean health insurance, whether one fund or sever or funds had been the most controversial issue. In Febrary 1999, the National Assembly passed the act of one fund system. From July 2000 separate funds will be unifed under new health insurance scheme. In this study we will analyze the policy making process on implementation, expansion and integration of health insurance system of Korea. And also analyse problems related to policy making.