• Journal of Teachers' Pension
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• v.2
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• pp.243-274
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• 2017

최근 우리나라는 유례를 찾아볼 수 없을 정도로 고령화 진행속도가 빠른 나라로 공적 연금재정과 연금제도의 지속가능성에 대한 관심이 증가하고 있는 상황이다. 따라서 사회보장제도 개혁에 성공한 국가로 잘 알려진 스웨덴 사례를 통해 사학연금제도의 유지 및 장기적 재정안정화에 시사하는 바를 찾고자 한다. 스웨덴 정부는 인구고령화에 따른 위험에 상대적으로 안전한 '명목확정기여(Notional Defined Contribution)'방식을 도입하여, 개인의 연금계좌에 연금보험료를 적립하여 수급시점에 본인이 부담한 보험료 상당액을 연금으로 돌려받을 수 있도록 운영하고 있다. 또한 경제상황이 예상 수준보다 침체되고 연금 재정수지가 악화될 경우 이와 연계하여 자동으로 연금가입자의 부담금을 높이고, 지출되는 급여액을 감소시키는 '자동재정균형장치(Automatic Balancing System)'를 도입하였다. 상기와 같이 기여와 급여를 명확하게 연계시키는 스웨덴의 명목확정기여 방식의 연금제도는 장기적 재정안정은 물론이고 안정적인 연금 급여를 제공한다고 평가되고 있다. 스웨덴은 연금개혁 후 확정기여(DC)제도로 전환하여 장기적인 제도 안정성을 추구하지만 사학연금은 확정급여(DB)제도를 유지하면서 급여수준의 하향조정과 보험료율을 점진적으로 상향시켜 재정안정성을 확보하는 것이 가장 큰 차이점이다. 스웨덴의 연금제도와 같이 공적연금의 틀을 유지하면서 사적연금의 장점을 최대로 수용한 명목확정기여 방식의 연금제도를 도입한다면 급격한 재정부담 없이 장기적으로 지속가능한 연금재정 안정화에 기여할 수 있을 것이다. 일견 스웨덴의 정치, 경제상황 및 문화적 특성 차이로 인해 스웨덴의 연금제도 방식을 획일적으로 사학연금제도에 적용하는 것은 불가능하다. 경제상황을 고려한 기여와 급여의 연계 강화를 개혁의 기본방향으로 설정한 스웨덴의 사례를 벤치마킹하여 사학연금 또한 거시경제상황과 조화를 이루는 제도개선 및 자동안정장치를 마련해 보는 것도 고려해 봄직 하다. 지속적으로 스웨덴 및 연금제도 선진 국가들의 연금개혁안을 재검토하여 사학연금제도에 현실적으로 적용할 수 있는 방안과 시사점들을 찾는 노력이 필요할 것이다.

• Korean Journal of Social Welfare
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• v.51
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• pp.5-28
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• 2002

The purpose of this paper is to examine the issues and the characteristics of the recent social security pension debate in the United States. For the purpose the transforming process from the funded system to the pay-as-you-go system in the 1930s, three alternatives of social security reform proposed by the Social Security Administration in 1996, and the other various alternatives proposed by the politicians, the business leaders and the scholars were analysed. While the alternatives were compared, the critical issues could be identified. The core issues were as follows. First, the individual accounts should be newly made or not? Second, who is the main administrator, government or private investment companies? Third, what is important, the inter-generational and the vertical income redistribution effect or the individual equity in social security pension system? Besides, the different positions of the social forces were also examined. The supporters of privatizing the social security pension, supporters of IA and PSA, prefer the value of equity, the effect of promoting savings, the private management of the social security funds, and the investment of the funds to the private capital markets. The supporters of pay-as-you-go system, supporters of MB, prefer the inter-generational and the vertical income redistribution effect of social security pension, and were convinced that fundamental changes of the systems are not necessary, and the insolvency problem could be overcome through a few reform, for example, increasing the rate and decreasing the benefits.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.