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KMID : 1124020150310030119
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Korean Social Security Studies
2015 Volume.31 No. 3 p.119 ~ p.144
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A Comparative Study On Health Care Financing Of 9 OECD Countries
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Shin Kee-Chul
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Abstract
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Medical expenditures of the national health insurance will be increasing sharply due to aging. Further it will be difficult to finance those expenditures entirely with social insurance premiums. Because of feeble labor market structures and loose social solidarity, it is necessary to study various financing tools for health care. In a survey of 9 OECD countries which have adopted social health insurance systems, we find that they charge public health insurance premiums to the retired persons. Especially Germany, the Netherlands and Switzerland do same rates. Also the central governments subsidize fixed portions of medical expenditures, fixed rates of premiums or premium reductions for poor families with general revenues. Surcharges for auto insurance premiums, special purpose value added tax for tobacco and alcohol, a fixed ratio of net profits of enterprises are also valuable tools of health care financing. In order to improve the long term fiscal sustainability of the national health insurance, various stake holders such as insureds, medical service providers and medical professions should reach to an agreement. The utmost values of health care systems are universal coverage, solidarity in financing, equity of access and provisions of high quality medical services. There is no magic bullet for improving fiscal sustainability keeping those four values. In order to reach social consensus for increasing premium or taxes, it is necessary to promote social trusts of stakeholders through widening health care benefits for catastrophic illness.
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KEYWORD
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Health Care Financing, Medical Expenditure for old age, Equity in Financing, Sustainability
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