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KMID : 0857920210240020147
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Yonsei Journal of Medical History
2021 Volume.24 No. 2 p.147 ~ p.181
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Response of doctors to the introduction of a compulsory designation system for medical institutions in accordance with the second and third amendment of the Medical Insurance Act in Korea
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Kim Jung-A
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Abstract
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Korea’s national health insurance does not provide medical institutions the freedom to decide whether or not to participate in the insurance scheme. This is known as the compulsory designation system for medical institutions. It was adopted and implemented by the second amendment of the Medical Insurance Act in 1976 and enforced with punishment by the third amendment in 1979.
This paper examines the introduction and implementation of this system between 1976 and 1979 and the response of doctors. The speed and non-transparency of the Ministry of Health and Society in the process of drafting this bill and the passive role played by the legislature under the Yushin dictatorship enabled this compulsory designation system in which doctors’ rights were violated. The Korean Medical Association dealt with the designation system as a top priority. However, it was clear that the designation system was a matter in which the Ministry of Health and Society would not compromise. In addition, doctors had to focus on negotiating fees while surviving expediently in the given environment; thus, they could not afford to fully oppose the designation system. Therefore, the Korean Medical Association chose to secure bargaining power rather than downright opposition so that all desired practitioners could participate. The main concern of the Korean Medical Association at the time was to prevent practitioners in clinics, where the medical delivery system was not well established, from lagging behind in this competition. The Yushin regime, which served as the background for these events, limited the professional body from effectively claiming its rights. Since then, the system introduced and maintained during this period has had a profound impact on doctors.
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KEYWORD
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Medical Insurance Act, National Health Insurance, Korean Medical Association, compulsory designation system for medical institutions, Yushin regime
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