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KMID : 1124020140300030121
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Korean Social Security Studies
2014 Volume.30 No. 3 p.121 ~ p.149
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A Study on the Medical Consumptions of Private Health Insurance Policyholders focusing on the hospitalization periods of 20 diseases
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Shin Kee-Chul
Kwon Hyuk-Sung
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Abstract
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There have been various researches on the medical consumptions by private health insurance policyholders since 2003 Insurance Law revision. Researchers have used two kinds of methods. Several researchers have used random sampling. And the others have used the Korea Health Panel Data. They concluded different views on medical consumptions by insurance policyholders. One reason is that complemental private health insurances are able to be purchased accident and disease coverages separately. Furthermore fixed indemnity insurances insure specific accidents and diseases. Therefore private insurance policyholders may show different reactions by specific accidents and diseases. This research analyzes hospitalization periods, average number of surgeries, total health expenditures between insurance policyholders and non-policyholders using 9 months of hospitalized patients caused by 20 kinds of sicknesses from April of 2011 to December. We found that insurance policyholders show moral hazard from 18 kinds of sickness. Especially, insured patients caused by cancers, arthrosis, sprains, and angina pectoris show longer periods hospitalizations which can not be explained as moral hazards. The reason of longer periods might be caused by intentional extension for marginal profits between actual costs and insurance claims. And it also might be caused by moral hazard by hospitals. These kinds of moral hazards could be aggravated if the government implements public health insurance policies increasing coverage ratio. We recommend to make a better policy for roles of public and private health insurances including sickness benefits. And we need to control hospitals in order to prevent moral hazards.
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KEYWORD
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Private Health Insurance, Medical Consumption, Moral Hazard, Hospitalization Periods
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