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KMID : 1170320060120010073
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Korean Journal of Health Economics and Policy
2006 Volume.12 No. 1 p.73 ~ p.90
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A Critical Review on Health Data Sharing between Public and Private health insurance
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Lee Sang-Yi
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Abstract
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In South Korea, Private Health Insurance plays an important role. In terms of the number of enrollees and premiums size, the Private Health Insurance (PHI) is significantly larger than any other country in the world. Meanwhile, Public Health insurance, which covers 97% of the population in Korea, is relatively weak and less comprehensive. In these circumstances, private health insurance companies, supported by economy-oriented government departments, are making requests for individual health data for their underwriting. Worse yet, several government departments led by the Ministry of Planning and Finance Department, are trying to revise current Insurance Law in order to insert an article that obligates the insurer (payer) to disclose private enrollees’ individual health data to a prospective PHI company. By contrast, the Ministry of Health and Welfare and National Health Insurance Corporation oppose individual health data provision to PHI companies, claiming that provision of the information to private health insurance companies is irrational in terms of various rationalities to the public health insurance. An important purpose of this article is to delineate on what ground individual health data from public health insurance can’t be channeled to private health insurance. For this, the article will discuss the characteristics of health data in theoretical perspectives, such as actuarial fairness vs, social fairness, use value vs. exchange value, and limitation on principal’s self-determination theories, and so on.
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KEYWORD
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health data, public and private health insurance, health data protection and management
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Listed journal information
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