• Health Policy and Management
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• v.15 no.4
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• pp.65-80
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• 2005

This study examines the effects of supplemental insurance on health care utilization and expenditures among cancer patients, who were hospitalized in a general hospital in Korea 2003. We find that those who purchase the supplemental insurance in addition to the social health insurance use more health care services and pay more than those who do not, suggesting insurance effects. This paper, however, cannot distinguish the moral effects of the health insurance from the selection effects due to adverse selection.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Health Policy and Management
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• v.33 no.3
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• pp.325-337
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• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• Journal of Preventive Medicine and Public Health
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• v.40 no.4
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• pp.329-335
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• 2007

Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.13-25
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• 2013

After studying FSMA 24, We found that the insolvency rule of financial institutions in FSMA consists of eight provisions: 1) voluntary arrangement, 2) administration order, 3) receiverships, 4) voluntary winding up, 5) winding up by the court, 6) bankruptcy, 7) provisions against debt avoidance, and 8) supplemental provisions in insurance cases. Insolvency provisions in FSMA explain powers and accountabilities of FSA in relation to these insolvency proceedings. Although there are some differences in proceedings, provisions entitle FSA the same status as creditors to petition the court, with a right to participate in related meetings and to be notified of any matters involving insolvency proceedings. The differences and implications between U.K.'s FSMA and Korean regulations are related to the insolvency rule of financial institutions. First, in FSMA, FSA has a comprehensive power to manage insolvency proceedings of financial institutions in a centralized way. However, Korean regulations have special laws to regulate insolvency in a decentralized way. The offices executing those laws are the Financial Services Committee, the Financial Supervisory Service, and the Financial Deposit Insurance Corporation. This characteristic results from an accelerated legislation procedures related to financial reform in 1997 Korean financial crisis. Second, FSA contains special provisions on continuation of contracts of long-term insurance considering the characteristics of insurance industry related to insolvency of financial institution. However, Korean insolvency rules applied to financial institutions do not consider industrial differences and the characteristics of financial contracts, so need to be supplemented in the future.

• The Korean Journal of Air & Space Law and Policy
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• v.6
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• pp.137-147
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• 1994

Clearly there are many legal arguments and criticisms surrounding the proposals for change in the Warsaw Convention and the need for a radical review. The question remains is unlimited liability the answer or should there be some other form of supplemental compensation and if so, what limits should be applicable. It does seem that the adopted limits of the Convention are seen by many as the first line of defence, which, dependent on political and cultural differences, the legal interpretation of contractual wording and the legal system globally have resulted in enormous differences in compensation paid whether or not the Convention limits were imposed. An example of this is in the United States, which highlights the significance of the problem in that domestic travellers without Convention Limits can, through the American legal system, obtain compensation in the multi-million dollar area for a death claim, whereas a passenger t1ying internationally would in the first instance be subject to Convention Limits. expensive legal action through litigation. To date, we can advise that insurers have not charged additional premium for unlimited liability coverage. Insurance rates as we have stated are hardening considerably. To date, average rate increases have been plus 56% for aircraft hull and plus 45% for liabilities. Insurers last year suffered global losses of around US $ 1.1 Billion against a premium income of US $ 800,000. The target premium income for 1993 is believed to be in the region of US $1.4 Billion.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.1-11
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• 2015

This study analyzed the tooth brushing behavior and oral health status of foreigner immigrant workers and obtained the following results. Statistical significance based on different general characteristics. Gender, educational background, period of stay, health insurance, medical expense coverage, and whether or not one has friends or regular gatherings were significant traits for frequency, while age, marital status, income, and health insurance were traits for part (p<0.05). Statistical significance (p<0.05) was found in marital status and health insurance for time used to brush teeth, period of stay and whether or not one attends a regular gathering for tooth brushing training, and gender, educational background, period of stay, roommate status, medical expense coverage, and whether or not one attends a regular gathering for supplemental oral product usage. The averages of decayed, missing, and filled teeth (DMFT) index and community periodontal index of treatment needs (CPITN) for general characteristics were 6.98 and 3.03 respectively, and gender, roommate status, income, health insurance for DMFT index, and gender, age, marital status, educational background, roommate status, income, health insurance for CPITN were statistically significant (p<0.05). Tooth brushing frequency and part showed statistical significance (p<0.05) for DMFT index based on tooth brushing behavior, while tooth brushing part and time used to brush teeth were significant for CPITN. DMFT index was high at 8.34 for '3 times or more' in tooth brushing frequency, while DMFT index was high at 7.91 and CPITN was low at 2.94 for tooth brushing part. '3 minutes or longer' in time used to brush teeth was the lowest in CPITN at 2.88. As a result of analyzing the correlation between tooth brushing behavior and DMFT index, CPITN, tooth brushing frequency and part in DMFT index, and tooth brushing part and time used to brush teeth in CPITN showed significance (p<0.05). Based on the above results, we must promote the significance of brushing teeth and implement continuous training for correct tooth brushing management to enhance the oral health of foreign immigrant workers.

• Korean Journal of Social Welfare
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• v.53
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• pp.285-310
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• 2003

As National Pension Scheme for all nation complete in 1999 through expanding application in cities, the public pension including Public Occupational Pension became main axis of old-age income maintenance. After 4years since then, now, it is only half of total National Pension insured persons who have been qualified to receive pension through participate and contribution. The other half of National Pension insured is left the excluded from public pension. This paper is intended to identify scale and characteristics of the excluded from public pension and to analysis its cause, and to explore policy measures for solving the excluded's problem. for current recipients over 60 years old generation, the its excluded's scale is no less than 86% of the old over 60 years. The probability of getting in the excluded is high in case of old elderly and female for current elderly generation. For future recipients 18-59 years working generation, the its excluded's scale is no less than 61% of the 18-59 years total population. The probability of getting in the excluded is high in case of 18-29 years and female for current working generation. As logistic regression analysis determinant factor of paying or not pension contribution for future recipients, it appear that probability of getting in the excluded for current working generation is high in case of younger old, lower education attainment, irregular employee, working at agriculture forestry fishery sector, construction sector, wholesale retail trade restaurants hotels sector, financial institution and insurance real estate renting and leasing sector in comparison with manufacturing sector, occpaying at elementary occupation, professionals technicians and associate professionals, sale and service workers, plant machine operators and assemblers, legislators senior officials and managers in comparison with clerks. The Policy measures for the current recipient old generation have need to reinforce supplemental role of Senior's pension(non-contribution pension) until maturing of public pension, because of no having chance of public pension participants for them. And the Policy measures for the future recipient working generation have need to restructure social security fundamentally corresponding with social-economic change as labour market and family structure etc. The pension system has need to change from one earner one pension to one citizen one pension with citizenship rights. At this point, public pension have need to manage with combining insurance's contribution principle and citizenship principle financing by taxes. Then public pension will become substantially universal social network for old-age income maintenance and we can find real solution for the excluded from.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.143-174
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• 2019

Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.