This study proposes a detailed improvement plan that identifies the current state of funding for medical insurance, and defines the institutional characteristics of each country.
Examining the selective medical welfare and universal health insurance of South Korea in terms of supply, problems including tax and financial burdens—such as insurance coverage— are likely to occur. In terms of efficiency, when the implicit marginal tax rates are high, income groups that are between medical welfare and health insurance will face a reversal phenomenon, where marginal tax rates exceed 100 percent. For these groups, motivation declines. In addition, examining property alone requires significant administrative costs, and there are many difficulties in implementations of medical welfare, in terms of efficiency.
Currently, health insurance is classified according to occupation. Employees join health insurance programs through their companies, and self-employed people join local medical insurance programs. However, there are exceptional cases in which covered employees opt for local medical insurance: people who are employed in companies with less than five workers, seasonal and temporary workers, and part-time and contract workers. In order to reduce issues regarding qualification, employees who work in companies with more than two workers (excluding private business owners and unpaid family workers) are allowed to join health insurance programs through their employers, so that the financial burden of local medical insurance is reduced. In order to settle limit unionism, the government must prevent the excessive involvement of the Department of Social and Health Services, in terms of administration and personnel matters of health insurance coverage.
Furthermore, in order to reduce medical costs for low-income families, the government should abolish the reimbursement period for certain adult diseases, or help patients receive health insurance benefits by slightly increasing the patients’ share of medical costs, so that the general financial burden of health insurance and medical costs are reduced. In addition, a system that requires citizens over a certain age to get thorough medical checkups for specific adult diseases should be introduced. A monetary system should be established in order to prevent patients from indiscriminately using emergency rooms or family medicine doctors in tertiary care centers. The government must review methods to adjust payment items for certain locations that use new medical technology or expensive equipment. It is also important to stabilize health insurance coverage through the improvement of the payment system for health expenditures.
Finally, Korea needs to improve the method of supplying subsidies, and adjust insurance coverage through fundraising efforts by the central government for the stability of regional insurance coverage. Through the participation of companies, public agencies, and health and medical insurance associations under local insurance, a health and medical central fund should be established. Flexible finance adjustments should be made through professional management and operation of funds. Reasonable health care funding for each local union will be increased if the government improves its support of subsidies, along with fundraising efforts of the central government.
의료보험재원조달방식의 개선방안(Ways to improve funding for medical insurance)
서울 : 한국개발연구원
|Series Title; No||정책연구시리즈 / 93-18|
|Subject Country||South Korea(Asia and Pacific)|
|Subject||Social Development < Health|
|Holding||KDI; KDI School|