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KMID : 1234820200210010069
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Korean Society of Law and Medicine
2020 Volume.21 No. 1 p.69 ~ p.105
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Constitutional Limits of the Medical Fee Payment System and the Unconstitutionality of Fixed Payment System
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Hyun Doo-Youn
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Abstract
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In the health care system, medical fee payment is a very important and basic factor. The National Health Insurance Act adopted a contract system, and the content of the contract is to be determined the unit price per relative value scale. Accordingly, in the National Health Insurance system, the costs of health care benefits are adjusted each year according to inflation or changes in economic conditions. On the other hand, in the Medical Care Assistance system, the Medical Care Assistance Act does not prescribe the method of determining the medical payment, and all matters are delegated to the Minister of Health and Welfare. Accordingly, the Minister has adopted a fixed-payment system for hemodialysis treatment since 2001. A constitutional petition was filed in 2017 against this fixed-payment system, and the Constitutional Court rejected the petition in 2020. In this study, we examine the meaning and content of the medical fee payment system, focusing on the above constitutional petition case, and present three principles as constitutional limits on the system. The first of its principles is the principle of legality, the second is the principle of prohibition of comprehensive delegation, and the third is the principle of proportionality. From that point of view, There are many unconstitutional elements in the fixed-payment system on hemodialysis.
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KEYWORD
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National Health Insurance, Medical Care Assistance, hemodialysis, medical fee payment system, relative value scale, fee-for-service, bundled payment, fixed-payment system
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