• 한국중재학회지:중재연구
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• 제28권4호
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• pp.43-59
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• 2018

This study aims to review various efforts required by medical institutions to prevent medical accidents in advance and to suggest the necessity of introducing liability insurance for medical accidents based on cases abroad and compulsory professional indemnity insurance at home. Over the past five years between 2013 and 2017, the number of inquiries regarding medical accidents and medical disputes has increased by 11.1 percent from 36,099 to 54,929, and the number of mediation and arbitration for medical disputes has increased by 14.3 percent from 1,304 to 2,225. Since some medical accidents even cause social problems, a compulsory insurance system for the liability of medical institutions for damages need to be introduced to promptly compensate the victims of medical accidents and to ensure compensation by medical personnel. In Korea, a system is in place to provide compensation for a client who suffers an accidental damage after receiving professional services, regardless of whether or not the professional service provider can provide compensation. In major foreign countries, a medical liability system is in place that is applied either by the principle of liability with fault, or the principle of liability without fault. In this study, the cases of compulsory insurance and semi-compulsory insurance in the US and Japan to which the principle of liability with fault is applied, as well as the case of New Zealand to which the principle of liability without fault is applied, were examined. It is necessary to urgently introduce the compulsory insurance system for the liability of compensation to prevent medical disputes and to compensate for the life and physical damages of the victims of medical accidents in domestic medical institutions. Doing so is expected to ensure fair compensation for the victims of medical malpractice and compensation by medical personnel, thereby improving medical practice.

• 의료법학
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• 제8권2호
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• pp.37-68
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• 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
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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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• 제29권2호
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• pp.206-219
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• 2019

This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

• 보건행정학회지
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• 제27권3호
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• pp.199-210
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• 2017

Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.

• 의학교육논단
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• 제24권1호
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• pp.18-34
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• 2022

The purpose of this study is to clarify the background of the controversial attempt to establish a new public medical school linked to compulsory service as a means of strengthening public healthcare in Korea, and to raise anticipated problems with possible solutions. In Korea, healthcare is predominantly provided by the private sector focused on medical care, rather than public healthcare, even under the national health insurance system. The government has been mainly in charge of public health and unmet medical services from a residual perspective, but health inequalities still exist. To resolve this issue, the government created the concept of public health and medical service (PHMS) from a universal perspective and tried to strengthen the infrastructure of public healthcare and to foster core PHMS doctors by establishing a new public medical school linked to compulsory service in medically vulnerable areas. This study investigated the reality and concept of the new public medical school planned by the government, and identified problems such as the possibility of obtaining accreditation and evaluation before its establishment, the side effects of dividing doctors' roles, the waste of huge amounts of resources, and insensitive policies. In conclusion, in order to resolve health inequalities in Korea, we need to train doctors through medical school education that strengthens the social responsibility of doctors along with strengthening public healthcare infrastructure, and to provide a better environment for doctors working in medically vulnerable areas through sophisticated policies.

• 항공우주정책ㆍ법학회지
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• 제33권2호
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• pp.169-197
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• 2018

본 연구는 우리나라의 항공보험 의무가입제도의 현황을 파악하고 외국 입법례와의 비교를 통해 우리 실정에 알맞은 합리적이고 구체적인 기준을 제시하고자 한다. 이를 통해 현행 법령의 개정방향을 밝혀 개선을 유도하고 궁극적으로 적절한 항공보험으로 항공기를 이용하는 우리 국민의 안전과 재산이 담보될 수 있는 환경을 조성하는 것을 목표로 한다. 특히 2017년 새롭게 시행된 항공사업법과 그 하위법령을 검토함으로써 향후 항공보험에 관한 입법적 개선방향을 제시하고 이로써 입법적 오류, 시행착오 등을 최소화할 수 있을 것으로 본다. 사고 발생 시에 수많은 인명과 재산이 손실되는 항공사고의 전손성, 순간성, 거대성이라는 특성을 감안할 때 항공운송산업의 지속적 성장을 유지하고 피해자를 위한 원만한 배상이 가능하도록 하기 위해서는 항공운송인에 의한 적절한 항공보험의 가입과 유지가 필수적이다. 이런 측면에서 근대 사법체계의 대원칙인 계약자유의 원칙을 수정하는 항공보험 가입의무의 강제가 설득력을 가지게 되는 것이다. 다만 외국의 입법례와 비교하여 우리나라의 항공보험 가입의무에 관한 법규정은 다음과 같은 쟁점들을 중심으로 재정비될 필요가 있을 것으로 본다. 첫째, 항공운송인에 대해 적절한 수준의 항공보험의 가입과 유지를 강제하는 것은 국가의 개인에 대한 금전적 의무를 강제하는 성격을 가지게 되므로 시행규칙이 아닌 본법에 규정되는 것이 타당할 것으로 생각된다. 이와 같은 규정의 태도는 다른 외국의 입법례에서 흔히 목격되는 사항이다. 둘째, 우리 법 규정은 "국제협약에서 규정하는 책임한도액"이라는 문구를 사용함으로써 여라 가지 다양한 경우의 항공손해배상에 대응하고 있다. 하지만 본문에서 살펴본 바와 같이 국제협약 중에서 어떠한 수단(legal tools)이 사용되는가에 따라 배상범위가 달라지는 점, 오늘날 승객에 대한 손해배상을 규율하는 몬트리올 협약은 항공운송인의 과실이 있는 경우 그 책임한도액이 철폐된 점, 책임한도액이 철폐된 점, 그리고 지상 제3자의 손해에 관한 로마협약체계에는 우리나라가 가입하고 있지 않은 점 등을 고려할 때 "국제협약에서 규정하는 책임한도액"은 더 이상 만병통치약이 되지 못한다. 셋째, 우리나라와 같이 좁은 영토를 가진 국가에서는 국내운송과 국제운송이 비행시간이나 거리에서 큰 차이가 있다. 따라서 항공보험 가입의무에 있어서도 국내운송과 국제운송을 나누어 규율할 필요가 있을 것으로 본다. 이러한 이중적 규율은 항공운송업에 새롭게 진출하고자 하는 신생 항공사에게 국제운송과 같은 필요 이상의 보험가입을 강제하지 않아도 되는 장점이 있다. 넷째, 무인비행장치의 사고에 따른 항공보험에 자동차손해보험을 준용하는 것은 무인비행장치 사고에 관한 특성을 충분히 이해하지 못한 것으로 보인다. 향후 무한한 발전가능성을 가진 무인비행장치에 관한 보험은 장기적인 관점에서 일반적인 항공보험과 분리하여 규율하는 것이 타당할 것으로 생각된다.

• 보건행정학회지
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• 제15권3호
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• pp.40-59
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• 2005

The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.

• 한국사회정책
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• 제20권3호
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• pp.171-195
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• 2013

산재보험의 현안 이슈 중의 하나는 인적 적용 범위에 관한 것이다. 우리나라에서는 근로기준법상의 근로자 개념과 산재보험법상의 근로자 개념을 일치시켜 적용하면서 사회적 보호 필요성이 제기되는 집단에 한정해서 특례규정을 적용하여 임시적으로 문제를 해결하여 왔다. 본 논문에서는 독일 사회법전과 문헌 연구를 통해 자원봉사자와 특수형태근로종사자 중심으로 독일 산재보험의 적용 방식을 분석하고 시사점을 도출하였다. 독일에서는 우리나라와 달리 의료기관이나 사회복지시설의 자원봉사자, 공공기관과 교회의 자원봉사자, 시민보호를 위한 자원봉사자, 생명구조 활동자, 헌혈자 및 장기 기증자 등을 법률에 의한 당연가입대상자로 적용하고 있다. 국가가 공익 목적의 자원봉사 활동을 적극 지원하여 자원봉사가 활성화되어 있으며, 이러한 지원의 일환으로 자원봉사 활동 관련 재해 위험을 산재보험제도를 통해 보호하고 있다. 산재보험의 적용대상이 종속적 고용관계에 있는 근로자에서 출발하여 확대되는 배경과 과정을 자원봉사자 중심으로 독일 문헌에 기초해 정리하였다. 본 연구를 통해 다음과 같은 시사점을 도출하였다. 첫째, 독일 산재보험제도는 종속적 고용관계에 있지 않은 사회적 취약집단에게 재해 보호 서비스를 제공할 수 있다는 것을 보여준다. 둘째, 사회복지 분야 자원봉사자에게 재해 보호 서비스를 제공할 필요가 있으며 적용방법으로 산재보험제도를 활용하는 것이 바람직하다. 셋째, 사회복지 분야 자원봉사자를 산재보험 당연가입대상자로 설정하여 제도를 운영할 필요가 있다. 넷째, 특수형태근로종사자에 대해서는 우리나라가 독자적인 해결방안을 강구해야 한다.

• 한국항해항만학회지
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• 제32권5호
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• pp.409-413
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• 2008

전국의 수상레저사업자를 대상으로 한 현재 사업현황과 수상레저안전법의 개정에 따른 관련규제에 대한 의식실태 설문조사를 통계 처리한 분석결과를 요약하면, 조종면허를 취득하거나 갱신할 때 일정시간의 안전교육을 받는 것에 대해 필요하다고 생각하는 사업자는 전체의 63.5%로 나타나 안전교육에 대해 대체로 찬성하였으며, 개인소유의 동력수상레저기구에 대한 등록제도 도입이 필요하다고 생각하는 사업자는 전체의 70.3%를 차지하여 등록제도에 대한 요구가 큰 것으로 나타났다. 수상레저 찰동 중에 발생할 누 있는 사고에 대비하여 수상레저기구에 대한 보험 또는 공제가입을 의무화하는 것이 필요하다고 응답한 사업자는 동력 및 무동력에 대해 각각 전체의 81.1%, 70.3%를 차지하여 원칙적으로 보험이 수상레저 활동에 필수적인 항목임을 확인할 수 있었다.