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지역의료보험의 재정안정화를 위한 개선방안(Measures for the stable local medical insurance fund)

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  • 지역의료보험의 재정안정화를 위한 개선방안(Measures for the stable local medical insurance fund)
  • 노인철; 이필도; 이충섭; 김수춘; 이종협
  • 한국보건사회연구원


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Title 지역의료보험의 재정안정화를 위한 개선방안(Measures for the stable local medical insurance fund)
Similar Titles
Material Type Reports
Author(Korean)

노인철; 이필도; 이충섭; 김수춘; 이종협

Publisher

서울:한국보건사회연구원

Date 1991-12
Series Title; No 연구 / 1991-21
Pages 290
Subject Country South Korea(Asia and Pacific)
Language Korean
File Type Link
Subject Social Development < Health
Holding 한국보건사회연구원

Abstract

This research aims to present measures to stabilize the medical insurance system, through an analysis on the financial structure of regional medical insurance systems.
Despite its relatively low income level, Korea successfully implemented its National Health Insurance System, which was expanded to cover all Koreans in the 12 years after its adoption. In the case of regional medical insurance systems, however, despite the central’s government’s massive budget allocation, its prospects are not all positive. This is because it was adopted relatively recently and it aims to cover rural residents, small business owners, and day laborers, who largely have a sense of relative deprivation.
Currently, the local medical insurance system is beset by a number of challenges. In terms of revenue, the irregular income levels of the insured and the lack of a measure to estimate increased income—which results in charging an inexact amount of insurance fees—are cited as major problems. Also, in terms of expenditure, the increase of hospital visit per capita, as many local residents are encouraged to do so since the adoption of the system, has been determined to be the main problem.
Securing stable funds for regional medical insurance systems is the prerequisite to maintain the systems in a sustainable manner. Therefore, in order to improve the current situation, systemic indices to be developed to impose fair insurance fees that reflect the insured’s incomes and assets. In addition, the central government should continue to support regional medical insurance programs, as it is a public good which is directly linked with the health of the residents, and which serves as a part of social safety net for rural residents, small business owners, and day laborers, who have been largely left behind in the process of the national economic development. Additionally, there should be a strict management and supervision system to prevent the waste of funding by overcharges or excessive medical treatments.

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