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A Study on Private Health Insurance in Korea (민간의료보험의 현황 및 활성화에 관한 연구)

  • 정기택
    • Health Policy and Management
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    • v.7 no.2
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    • pp.109-146
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    • 1997
  • This study explores the feasibility of activating private health insurance in Korea. The rationale for expanding private supplementary health insurance can be found in many cases of health care reforms in the European countries. Private health insurance can not only relieve the financial distress of the government health insurance programs but also offer the medical institutions incentives to improve the quality of medical care. In Korea there is no supplementary health insurance that reimburses for various kinds of diseases based on a well designed fee schedule. Recently, the cancer insurance is the best seller in the health related insurance market. As observed in the U. S. case, the cancer insurance which pays the predetermined amount (indemnity coverage) regardless of the medical charges incurred to the patient is limited in its coverage for the insured. To provide better protection against catastrophic diseases, the government should give insurance companies incentives to develop health insurance products that cover multiple diseases rather than a single disease. Consumers can hardly understand and compare complex insurance products. To resolve the information asymmetries, the government should publish a consumer report that compare various health insurance products in a user friendly way. In the long run, insurance companies will plan to sell health insurance products that charge risk related premium only when insurers accumulate the underwriting know-hows, the government shares data on various health statistics including claims and demographics, and risk pool for high risk patients is well established and subsidized by the government.

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A Normative Review on Non-Invasive Prenatal Diagnosis (NIPD): Focusing on the German Discussion on PrenaTest®

  • Kim, Na-Kyoung
    • Development and Reproduction
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    • v.25 no.2
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    • pp.113-121
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    • 2021
  • This article aims to introduce German discussion on the approval of the non-invasive prenatal diagnosis (NIPD), which started with the development of PrenaTest® by LifeCodexx AG. The discussion started with the concern that the non-invasive nature of NIPD, such as PrenaTest®, may rapidly expand the use and scope of similar tests, thus leading to a new era of eugenics. Based on this concern, the need for clear clinical guidelines on specific indications for NIPD has been suggested. Along the same line, it was discussed whether PrenaTest® is against the Basic Law prohibiting discrimination on grounds of disability and whether the test is outside the scope of the purpose of gene testing limited by Genetic Diagnosis Act. Through such discussion, the Federal Ministry of Health of Germany established the preconditions for inclusion of NIPD in the German public health insurance system. For this, the German motherhood guideline was amended and the information for the insured persons provided to pregnant women was included in the amended guideline. Such discussion made in Germany provides insight on which points should be considered when various gene testings are accepted in Korea, in which genetic communication has not been systematized yet. In particular, German counseling system for pregnant women will provide valuable insights for Korea where the direction for regulations on abortion has not been established even after the ruling by the Constitutional Court that charges for abortion are against the constitution.

Effect of Work on Medical Expenditures by Elderly: Findings From the Korean Health Panel 2008-2013

  • Hyun, Min Kyung
    • Safety and Health at Work
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    • v.9 no.4
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    • pp.462-467
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    • 2018
  • Background: This study was conducted to investigate the effects of work on medical expenditures by the elderly. Methods: Data pertaining to individuals aged 65 or older collected by the Korean Health Panel 2008-2013 were used. The effects of work on medical expenditures were analyzed in a panel tobit model adjusted for several variables of demographic factors, socioeconomic factors, and health factors for health care. Data were also analyzed based on age groups (65-74, $75{\leq}$), type of work (waged or self-employed), and working time (daytime work or night time work). Results: Among the elderly older than 65 years, 34-37% were workers. Work among the elderly reduced medical expenditures relative to nonworking elderly. Specifically, medical expenditures were lower in individuals older than 75 years, as well as among those who were self-employed insured and had medical aid insurance and those who exercised. However, medical expenditures were higher among females, married individuals, those with a higher household income, and those with a chronic disease. Elderly wageworkers showed reduced medical expenditures than nonworking elderly and elderly daytime workers did. Conclusion: The elderly population's work, especially wage work and daytime work, reduced medical expenditures relative to no work. These results provide valuable information for policymakers by indicating that work was associated with lower medical expenditures than no work. If elderly work is to be encouraged, it is necessary to provide a variety of high-quality wage work.

Duty of Fair Presentation after the Enactment of the Insurance Act 2015: The Case of Korea and China

  • Ahn, Tae-Kun;Kim, Sung-Ryong;Peng, Tian
    • Journal of Korea Trade
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    • v.24 no.2
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    • pp.1-14
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    • 2020
  • Purpose - The purpose of this paper is to analyze the reformed duty of fair presentation provisions and related caselaw of the Insurance Act 2015 to gain a clearer understanding of the differences between the Act and the preceding legislation. Design/methodology - The authors analyzed caselaw from South Korea and China that involved breaches of the duty of disclosure. Cases highlighting differences between the duties of disclosure and fair presentation were selected. Findings - Changes in the practice of marine insurance laws are expected from the application of the reformed duty of presentation provisions. In particular, the rights of the insured are expected to increase, resulting in the fairer conduct of insurance contracts. Due to the fact that the Insurance Act 2015 has only recently taken effect, the provisions of existing caselaw have not yet been applied. This has limited the authors' scope of analysis. Originality/value - This paper describes the implications of the duty of fair presentation by analyzing caselaw from South Korea and China that involves the duty of disclosure. To the best of the authors' knowledge, this is the first paper that investigates the reformed duty of fair presentation provisions of the Insurance Act 2015 in the context of the legislation's implications for trade practices.

A Study on the Properties of Latex Modified Concrete using Recycled Coarse Aggregate (재생굵은골재를 이용한 라텍스 개질 콘크리트의 특성에 관한 연구)

  • Yoo, Deok-Ryong;Go, Seong-Seok
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.10 no.5
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    • pp.147-156
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    • 2006
  • This study is purposed to improve the performance of concrete made of recycled coarse aggregate. For this, recycled aggregate concrete was produced with SBR latex, and fluidity, dynamic performance and drying shrinkage were examined. According to the result, with mixing 6% of SBR latex, fluidity having resistance against segregation can be insured and compressive and flexural strength was increased. Especially the increment in terms of flexures was remarkable. In addition to, with above mixing ratio, drying shrinkage was reduced. Therefore there is a strong inference that superior recycled aggregate concrete can be produced with using 6% of SBR latex.

A STUDY ON THE SATISFACTION FACTORS OF THE DISABLED WHEN USING DENTAL CARE SERVICES (장애인의 치과의료서비스 이용 시 만족 요인에 관한 연구)

  • Cho, Hye Lim;Kim, Yung Jae;Yoon, Tai Young
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.9-21
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    • 2014
  • This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

The Examination of Construction Status on Multi-pillar System for Old Age Income Security in Korea (한국 다층노후소득보장체계 구축양태의 경험적 검토)

  • Han, Sinsil;Joo, Soojeong;Shin, Seounghee
    • Korean Journal of Social Welfare
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    • v.67 no.1
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    • pp.215-237
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    • 2015
  • This paper aims to check the multi-pillar pension system in Korea. That is why, We analyzed the insured status of people in terms of multi-pillar pension system including National Pension Service, Private Pension, Retirement Pension over time. The main findings are as follows; firstly, the 'multi-pillar type'(27.7%), the 'public pension type'(12.8%) and the 'insecure type'(59.6%) have been formed. Secondly, any socio-demographic factors like labor market status, gender, age et cetera could not guarantee the pension right for multi-pillar system. As a result, we emphasize that including the 'insecure type' into public pension schemes is a prerequisite for establishing the multi-pillar pension system.

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The study for recent changes of disease-mix in health insurance data (의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -)

  • Yu, Seung-Hum;Jung, Sang-Hyuk
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.345-357
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    • 1990
  • Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

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A Study for Risk Factors of Mild and Moderate.Severe Hypertension (경증고혈압, 확정역고혈압의 위험요인에 관한 연구)

  • Kim, Eun-Ju
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.350-361
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    • 1998
  • In an attempt to examine the risk factors and analyze an odds ratio for risk factors associated with mild and moderate. severe hypertension, this study was carried out from August, 1987 to September, 1997. From periodic health examinations of insured adults, 747 subjects were assigned to nomotensives, mild hypertensives and moderate' severe hypertensives. Major findings obtained from the study are as follows: 1. The Body mass index(BMI) was revealed a significant difference among the 3 groups. Also, there was a significant positive correlation between the BMI and systolic, dyastolic blood pressure. 2. Cholesterol was revealed to be significantly different among the 3 groups. Also, there was a significant positive correlation between the cholesterol and systolic, dyastolic blood pressure. 3. Urine protein and a cardiovascular family history was revealed to be significantly different among the 3 groups. The presence of urine protein and cardiovascular family history were significantly higher in hypertensives than nomotensives. 4. A preference for salty food, a preference for flesh and the frequency of flesh eating were not significantly different among the 3 groups. 5. Smoking habits, frequency and duration of cigarette smoking were not significantly different among 3 groups. 6. The habit of alcohol consumption and the frequency and duration of alcohol consumption were not significantly different among the 3 groups. 7. The habit of exercise and its frequency and duration were not significantly different among the 3 groups. 8. Statistically significant elevated odds ratios were noted in the following BMI(mild hypertensives; 2.48, moderate. severe hypertensives ; 4.65), urine protein(mild hypertensives ; 2.37, moderate. severe hypertensives; 6.77), cholesterol(moderate. severe hypertensives ;1.64), cardiovascular family histoy(moderate severe hypertensives; 4.77). Based on these results, the significant risk factors of mild, moderate. severe hypertension were BMI, cholesterol, urine protein, and family history, but diet, smoking, alcohol consumption, and exercise had no significant association.

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Distribution of medical status and medications in elderly patients treated with dental implant surgery covered by national healthcare insurance in Korea

  • Lee, Kyungjin;Dam, Chugeum;Huh, Jisun;Park, Kyeong-Mee;Kim, Seo-Yul;Park, Wonse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.2
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    • pp.113-119
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    • 2017
  • Background: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. Method: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. Results: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. Conclusion: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.