The medicaid program has been implemented in a superficial and perfunctory manner for twenty years since 1977 when the medicaid program initiated. It is attributed to the lack of budget for medicaid program resulted from "growth first, welfare
later"
policy, not to mention many manegerial problems and the indifference on the medicaid program compared to the medical insurance program. Accordingly, this study investigated the fundamental meanings implied by medicaid program and the ideologies
of
social security. Based on these meanings and ideologies, the problems of medicaid program were identified and policies to cope with problems were suggested.
First of all, the ideologies of social security embodied by the relevant laws in Korea are "the guarantee of the minimum standard of living" and "the harmonization of efficiency and equity" On the other hand, the meanings of the medicaid program
are
"guarantee of the right to live" and "the minimum level of health insurance", which are extremely passive. However, the social security and medicaid program that are currently being undertaken are not able to realize even these passive meanings
and
ideologies. These meanings and ideologies should be revised in order to improve the quality of life to the international level as follows :
Fist, " the guarantee of the minimum standard of living" and "the guarantee of right to live" should be revised as "the guarantee of dignity of human life" while "the harmonization of efficiency and equity" should be revised as "the harmonization
of
efficiency and the enhanced equity" and "the minimum standard of medical insurance". "the socially acceptable level of medical insurance"
As a result of reviewing medicaid program based on the above fundamental meanings and ideologies, the following problems were identified.
First, the scope of medicaid program does not cover the poor class who actually need medicaid services.
Second, despite the fact that the majority of people who are beneficiaries of the second category of medicaid service should receive the first category of medicaid service, many of them cannot receive the proper services.
Third, medical institutions for medicaid program should correspond with those for medical insurance, which means the discrimition in the access to medical services.
Fourth, compared to medical insurance, medicaid program beneficiaries receive discriminatory services in terms of level and scope of medical services.
Fifth, the budget for medicaid program is extremely insufficient.
Accordingly, the following policies can be suggested.
First, the scope of medicaid program should cover all the needy people.
Second, the beneficiaries of the second category of medicaid service should be switched over to the first category based on the medical need and the ability of self-support. Among the beneficiaries of self-support program, 48.8% which have no
work
ability, 28.2% which have no possibility of self-support and 18.9% which have the high need of medical services can be converted to the first category.
Third, the medical institutions for medicaid program should correspond with those for medical insurance, especially pharmacies, dental clinics and tertiary general hospitals.
Fourth, the discriminatory should be improved. The treatment days and scope of medical services which reveals the discrimination externally should be upgraded to the level of medical insurance.
Fifth, the budget for the medicaid program should be expanded to the level of developed countries gradually, At the same time, the raw cost of treatment should be reduced in terms of public interests.
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