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.
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.
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.
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.
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.
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.
The purpose of this study is to present a reasonable and concrete standard for the Korean aviation insurance compulsory subscription system. Through this, we aim to improve the current revision of laws and regulations, and ultimately create an environment in which the safety and property of the Korean people who use aircraft with appropriate aviation insurance can be secured. In particular, by reviewing the aviation business law and its new laws and regulations enacted in 2017, the legislative improvement direction of aviation insurance will be proposed. In order to maintain the continuous growth of the air transportation industry and to make amicable compensation for the victims, considering the characteristics of the total accident, instantness, and giganticness of air accidents in which a lot of people and property are lost in the event of an accident, adequate insurance coverage is essential. In this respect, the compulsory insurance to amend the principle of freedom of contract, which is the great principle of the modern judicial system, will be persuasive. However, in comparison with foreign legislation, the legal provisions on Korea's obligation to comply with aviation insurance need to be revised around the following issues: First, it is reasonable to enforce the regulation of the mandatory aviation insurance by legislation from the Congress not by administrative regulations. Because it will force the monetary obligations of the individual such as common air carriers. Second, our law regulations respond to various kinds of air damages by using the phrase "limit of liability stipulated in international conventions". However, as we have seen in the text, the range of compensation are various according to the use of legal instruments in international conventions such as the Montreal Convention, which governs the compensation of passengers for damages to passengers today. Third, in countries with narrow territories, such as Korea, there are big differences in flying time and insurable risk between domestic and international transportation. Therefore, it is necessary to divide domestic transportation and international transportation even in the obligation to join the insurance. This dual discipline has the advantage for rookies in air carrier market who mainly start their business from domestic service. Fourth, according to Korean law, the regulations of automobile loss insurance is applicable to the aviation mandatory insurance of unmanned aerial vehicle accident which is lack of persuasion. In the future, it will be appropriate to discipline insurance for unmanned aerial vehicles with unlimited potential for development from a long-term perspective.
Jeong, Hyoung-Sun;Lee, Eui Kyung;Kim, Eun Jung;Ryu, Gun-Chun;Song, Yang Min;Kim, Sun-Ju
Health Policy and Management
/
v.15
no.3
/
pp.40-59
/
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.
One of the current issues in Workers' Compensation Insurance is about the coverage range. Korea uses the definition of worker under the Labor Standards Act in Workers' Compensation Act and solved the problems associated with the coverage range of insurance group by the exceptional clause only for the groups which was raised about the need for the social protection. The purpose of this paper is to draw implications for solving problems which are associated with the coverage range of insurance group by reviewing the German literature. We focus on volunteers and persons in special types of employment. German government supports the activity of volunteers by providing with the protection service against the accidents. This paper shows how the coverage range is extended from the dependent employees in the introduction of the Workers' Compensation Insurance to the people who need social protection focusing on the volunteers. The implications of this research are following. First, German system shows that Workers' Compensation Insurance can be extended to the groups which do not belong to the dependent employee but are worthy of protection. Second, it is necessary to provide volunteers in the social welfare system with the protection service against the accidents and the statutory accident scheme is recommendable to use. Third, volunteers in the social welfare system need to be compulsory insured. Fourth, Korea should find their own way in solving problems associated with persons in special types of employment.
This study came to the following conclusions through the survey which was conducted to ocean leisure business runners to find out current business situation and the perceptions about the revised regulations the safety law of water leisure. This survey showed that most of the respondents agreed about receiving water safety training for regulated time when they obtain or renew their licenses. 63.5% answered that water safety training is needed. There was a considerable demand for registration system of leisure boots. 70.3% presented that registration system of private leisure boots should be introduced. It is confirmed that insurance is an essential fact for ocean leisure activities. 81.1% for leisure boots and 70.3% for non-leisure boots respectively answered that private insurance or fraternal insurance need to be imposed as a compulsory condition in case of accidents during ocean leisure activities.
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