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KMID : 1235020100040010075
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Health Service Management Review
2010 Volume.4 No. 1 p.75 ~ p.85
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An Empirical study on benefit plans of the National Health Insurance system between the expansion of the benefit for diseases and the expansion of the benefit for medical expenditure
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Kim Jung-Hoon
Jung Kee-Taig
Shine Eun-Kyu
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Abstract
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The national health insurance act was initiated in 1977. This act has maintained the low burden & low benefit`` policy. Also, the low coverage rate did not seem to be solved due to the shortage of the finance. To fix the low coverage rate of the national health insurance, the government introduced a new plan in 2005. The plan was set a goal to increase the coverage rate as the average level developed countries had. The government suggested a benefit plan based on the expansion of the benefit for diseases. However, this plan was criticized by many because high risk patients could not have enough benefits when they had diseases the new list in the expansion of the benefit for diseases was not held. This study suggested the expansion of the benefit for medical expenditure as an alternative way in order to increase the coverage rate. This study compared the coverage rate of the patients with high cost when the same amount of money applied to two different benefit plans. The medical security for patients with high cost was good when the out-of-pocket payment of limit system, one way for the expansion of the benefit for medical expenditure, was expanded. The expansion of the out-of-pocket payment of limit system is a proper way for increasing the coverage rate of the national health insurance.
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KEYWORD
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plan of expanding benefit for strengthening the public coverage in the national health insurance, the expansion of the benefit for diseases , the expansion of the benefit for medical expenditure, out-of-pocket payment of limit system
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