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KMID : 0387320040140020034
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Korean Journal of Health Policy and Administration
2004 Volume.14 No. 2 p.34 ~ p.57
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Priority-setting in Expanding the Basic Benefit Package in Korean Health Insurance Scheme
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Jeong Hyoung-Sun
Kim Ju-Kyeong
Lee Kyu-Sik
Shin Eui-Chul
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Abstract
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Universal health insurance normally requires a basic benefit package, whose design intersects with almost all other aspects of the health insurance debate. Despite its central importance, basic benefit package has not received the analysis it deserves in Korea.
The issue of how to decide which health services should be delivered and to whom has been a matter for consistent policy debate. Many industrialized countries observed in this study have been dealing explicitly or implicitly with the basic benefit package. The methods vary from having a specific positive list of services (Bismarkian countries) to the use of guidelines (Beveridgian countries).
The purpose of this paper is to form the underlying principles and process for determining what is included or left out by getting accurate and representative responses from health-related personnel. Mail survey is used. Economic burden for treatment, seriousness of disease and urgency of treatment are ranked at the first three priorities. Services that had been suspended because of financial crisis in health insurance scheme in 2001 were selected as items which should firstly be expanded into coverage. Diagnostic test against heart disease and vaccination were also selected as items which should additionally belong to the list of covered services.
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KEYWORD
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Basic Benefit Package, Guaranteed Health Care Package (GHCP), priority-setting, principles and guideline, criteria
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