This study reviews and analyzes employee health insurance and the health insurance system for government officials and private school employees in terms of income redistribution, to determine improvements for the public health insurance system.
The income redistribution policy can be divided into two categories: policy designed to protect those in low-income brackets, and policy that promotes the earning capacity of low-income groups. The income increase of low-income families can be promoted through cash or in-kind transfer. The negative income tax or the income security policy through social security are considered cash transfers, while full or partial support for the school lunch program, health service, and housing are in-kind transfers. The policy for the promotion of the earning capacity of low-income people is designed mostly to remove obstacles to their employment or improve their productivity. However, neither one is sufficient for effective income redistribution across income strata.
The income redistribution policy should encompass both categories as social security policy is widely used as an effective means of income redistribution across the world.
This study analyzes how the medical insurance system in Korea affects income redistribution among subscribers to the employee health insurance or health insurance for school employees. From our analysis, this study presents the following suggestions:
First, medical charges should be unified to reduce the burden of medical treatment costs from those who are not currently eligible for medical insurance.
Second, the health premiums for those who work at schools and government offices on islands or remote areas should be reduced and the health premiums for subscribers to the health insurances for government offices and private schools in areas without sufficient medical infrastructure should also benefit from the premium reduction stipulation.
Third, in order to relieve the economic burden on low-income individuals due to the deductible system, and reduce inequality in terms of insurance payment due to dependency rates among income brackets, premiums should be differentiated in accordance with income. Furthermore, premiums for applicants who belong to the lowest income bracket should be lowered, while premiums for individuals whose monthly income is higher than the average should be raised.
Fourth, the insurance benefit ratio of the employee health insurance is at 74 percent, and that of the government official and private school health insurances is at 85 percent, and the accumulated reserve fund of the employee health insurance totals KRW 118.4 billion, and that of the government official and private school medical insurance is KRW202 trillion as of at the end of 1981. This means that the eligibility for insurance payment should also be adjusted as the legal reserve (which covers expenses for insurance payment for one year) is accumulated faster than planned by setting aside 5 percent of the expansion of average payment expenses for three years.
Fifth, the current unified medical charge system applied to all hospitals results in the concentration of beneficiaries of medical insurance into general hospitals, ineffective utilization of high-quality human resources and facilities, and high social cost despite differences in the quality of medical facilities and equipment among hospitals.
Sixth, the premiums for insured persons living in areas with poor accessibility to medical facilities should be reduced and the government should pay in full.
Finally, as insurance recipients pay benefits after they lose their eligibility, the insured should be able to receive insurance payments until one month after the termination of their employment.
의료보험의 소득재분배효과 분석(An analysis of the effect of medical insurance on income redistribution)
서울 : 한국개발연구원
|Journal Title; Vol./Issue||한국개발연구:vol. 4(issue 4)|
|Subject Country||South Korea(Asia and Pacific)|
|Subject||Economy < Macroeconomics
Social Development < Social Welfare
|Holding||KDI; KDI School|