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KMID : 1124020170330020001
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Korean Social Security Studies
2017 Volume.33 No. 2 p.1 ~ p.15
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Implication of the Korean Blue Cross Health Insurance on Health Security System
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Kang Sung-Wook
You Chang-Hoon
Choi Ji-Heon
Kwon Young-Dae
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Abstract
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The Korean Blue Cross Health Insurance had played its role on covering many of Busan citizens as non-profit voluntary health insurance from 1968 to 1989. This paper provides a clue to solve the problem of Korea mandatory national health insurance such as low accountability as well as problem of for-profit private health insurance such as cream skimming and adverse selection. This study is based on the literature review of Korean Blue Cross Health Insurance as well as a focus group interview with the its stockholders. Anyone residing in Busan was able to enroll the Korean Blue Cross Health Insurance which required the enrollee the same fixed premium per capita irrespective of age and sex. Major decisions, such as insurance premiums and benefits was made after sufficient discussion process via the Board of Directors, Management Committee, General Assembly of delegates, and the decision was unanimous. The enrollee should copay for health services utilized by them and there was a contract for fee and range of benefits between medical institutions and the Korean Blue Cross Health Insurance. As an alternative to commercial-type private health insurance, on the other hand, an example for overcoming such limited participation of the Korea national health insurance and the rigidity of the organization`s operations, the Korean Blue Cross Health Insurance which pursues non-profit-type private insurance have the historical significance.
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KEYWORD
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Korean Blue Cross Health Insurance, Private Health Insurance, Moral Hazard, Blue Cross
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