HEALTH INSURANCE SYSTEM IN KOREA
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1 HEALTH INSURANCE SYSTEM IN KOREA
2 I. Introduction II. III. contents (1) Outline of the Korean National Health Insurance Program (2) National Health Insurance Act (3) The Characteristics of the KNHI Body (1) Health Insurance Application System (2) Coverage of Health Insurance (3) The Incentives and the Necessities of the NHI (4) Limitatiton of Medical Insurance System (5) Quality of medical insurance of the United States Conclusion (1) The Comparison of two nation's health insurance (2) The Plan to Complement the Insurance System of Each Nation
3 Outline of the Korean National Health Insurance Program One of the Major Social Security Program Nearly all the Koreans are the beneficiaries of the Program National Health Insurance Corporation is the Main Supervising Institution
4 National Health Insurance Act Two Acts regulating the NHI program - National Health Insurance Act - Financial Stabilization Act The main objective of the NHI Act - To integrate the multi-insurer system of medical insurance into a single insurer system - To enhance the operation efficiency and equity of contribution
5 The Characteristics of the KNHI NHI is the system to promote the welfare of Koreans by government. Insurance bill is not imposed at the same rate on all the people but is discriminated depending on the beneficiary s capability. Regardless of how much a person paid the insurance bill all of them receive same amount when disease or fatigues happen.
6 The Present Condition of the population which medical treatment guaranteed is applied 60,000 Total Population Medical Care Guranteed Health Insurance Covered 50,000 40,000 30,000 20,000 10,
7 Health Insurance Application System
8 Coverage of Health Insurance (unit :1,000 persons, %) Classification Health Security Insurer Insured Number of persons Percent Total population 47, Health Insurance National Health Insurance Corporation Sub-total Ordinary employees Employees of government and private schools Self-employed of rural and urban areas 46,379 18,503 4,664 23, Medical Care Local Government Low income households 1,
9 The Incentives and the Necessities of the NHI Recognition for importance of Health Care Benefit Collective Settlement effort to cope with the sudden Rise in health care cost The preparation against the prediction impossibility of the time when the medical expense is necessary and of the medical expense sum in total
10 Health Insurance Benefits and Cost-sharing Categories of Health Insurance Benefits Recipient Benefits-incash Benefits-inkind Health care Benefits Health checkup Health care Allowance Funeral Allowance Compensation Allowance for Excess Co-payment Compensation Allowance for Aid Appliances Insured, Dependents Insured, Dependents Insured, Dependents Person who holds a funeral ceremony Insured, Dependents The insured and dependents as disabled persons registered in accordance with the Welfare Act for the Disabled
11 Limitatiton of Medical Insurance System Essential limit of medical insurance The limit against a grant ratio The limit against an insurance bill The limit in government subsidy
12 Quality of medical insurance of the United States Provides medical treatment service like Korea s i ndividual hospitals. Medical insurance is in the form of private insurance. There are Medicare and Medicaid for the people incapable of joining the private insurance and for the old and the poor.
13 The Comparison of two nation's health insurance Korea-mainly public insurance system P:The whole nation approach to medical treatment service with ease N:Low quality of health care service and waiting term being too long US-mainly private insurance system P:High quality of health care service N:Too high medical bill results in the people who don t receive sufficient medical service.
14 Total expenditure on health Total expenditure on health (1965~1998) Korea United States Unit : million dollar Source : OECD Health Data 1999.
15 The public coverage against medical care cost The public coverage against medical care cost (1965~1998) Korea United States Unit : % Source : OECD Health Data 1999.
16 The Plan to Complement the Insurance System of Each Nation Korea - Management innovation - Insurance finance - Improvement of service - Innovation of organization - The Utilization of market power to supplement efficiency United States - Adoption of the form which is a fusion of private and public insurance - The conversion from public insurance to private is not easy due to the serious lobby of civil insurance companies.
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