• Title/Summary/Keyword: Compulsory Insurance

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A Study on the Introduction of Liability Compensation Insurance to Prevent Medical Dispute (의료분쟁 예방을 위한 책임보상보험 도입에 관한 연구)

  • Kim, Kee-Hong
    • Journal of Arbitration Studies
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    • v.28 no.4
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    • pp.43-59
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    • 2018
  • This study aims to review various efforts required by medical institutions to prevent medical accidents in advance and to suggest the necessity of introducing liability insurance for medical accidents based on cases abroad and compulsory professional indemnity insurance at home. Over the past five years between 2013 and 2017, the number of inquiries regarding medical accidents and medical disputes has increased by 11.1 percent from 36,099 to 54,929, and the number of mediation and arbitration for medical disputes has increased by 14.3 percent from 1,304 to 2,225. Since some medical accidents even cause social problems, a compulsory insurance system for the liability of medical institutions for damages need to be introduced to promptly compensate the victims of medical accidents and to ensure compensation by medical personnel. In Korea, a system is in place to provide compensation for a client who suffers an accidental damage after receiving professional services, regardless of whether or not the professional service provider can provide compensation. In major foreign countries, a medical liability system is in place that is applied either by the principle of liability with fault, or the principle of liability without fault. In this study, the cases of compulsory insurance and semi-compulsory insurance in the US and Japan to which the principle of liability with fault is applied, as well as the case of New Zealand to which the principle of liability without fault is applied, were examined. It is necessary to urgently introduce the compulsory insurance system for the liability of compensation to prevent medical disputes and to compensate for the life and physical damages of the victims of medical accidents in domestic medical institutions. Doing so is expected to ensure fair compensation for the victims of medical malpractice and compensation by medical personnel, thereby improving medical practice.

COMPARATIVE ANALYSIS ON TIME SERIES MODELS FOR THE NUMBER OF REPORTED DEATH CLAIMS IN KOREAN COMPULSORY AUTOMOBILE INSURANCE

  • Lee, Kang-Sup;Kim, Young-Ja
    • The Pure and Applied Mathematics
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    • v.11 no.4
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    • pp.275-285
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    • 2004
  • In this paper, the time series models for the number of reported death claims of compulsory automobile liability insurance in Korea are studied. We found that IMA${(0, 1, 1)}\;{\times}\;{(0, 1, 1)}_{12}$ would the most appropriate model for the number of reported claims by the Box-Jenkins method.

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A Study on the Typology of Social Insurance Policy Instruments in Korea (우리나라 사회보험 정책수단의 유형에 관한 연구)

  • Noh, Shi-Pyung
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.5
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    • pp.109-117
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    • 2014
  • This study tries to find the policy instruments that have used in the process of social insurance policy implementation. The results can be summarized as follows: First, in case of compulsory policy instrument, the government uses the regulation, public enterprise and government insurance in the process of implementing of all the social insurance policy. Second, in the case of mixed policy instrument, the government use the user' contribution in the process of implementing of all the social insurance policy but the subsidy was used in the process of implementing of the medical, pension, unemployment and long-term care insurance for the aged policy. Also, the information and discipline was used in the process of implementing of unemployment insurance policy and the partnership was used in the process of implementing of long-term care insurance for the aged policy. Third, in case of voluntary policy instrument, the government uses the family and community in the process of implementing of almost the whole social insurance policy.

Approach to History and Problems of Health Insurance through Politics of Law (국민건강보험법의 발전과정과 법정책적 과제)

  • Cho, Hyong-Won
    • The Korean Society of Law and Medicine
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    • v.8 no.2
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    • pp.37-68
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    • 2007
  • Health insurance has gone far toward solving Korea's health related problems through thirty years. Health Insurance as social security system has a role of national system to secure national health. But there are many problems in health insurance. There is a dispute about many issues, coverage of health security, compulsory appointment of health insurance organization, coverage and level of health insurance benefit, decisionmaking right of health insurance price, examination of health insurance etc. Generally, the opinion for health insurance policy to be leaded by nation sets against the opinion to be leaded by private sector. It is necessary to study politics of law, constitute law and comparative law for rational solving these problems. If desirable setting of health law system can be made, legal system must be set during a long time and be discussed synthetically in different standpoint.

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Achievements and Challenges of 40th Anniversary Health Insurance (건강보험 40년 성과와 과제)

  • Lee, Kyu Sik
    • Health Policy and Management
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    • v.27 no.2
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    • pp.103-113
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    • 2017
  • There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

An Examination of the Exactitude of Legal Application behind the National Health Insurance Corporation's Practice of "Collection and Disbursement" of Paid Medical Expenses (With an Emphasis on Arbitrary Denial of Coverage) (국민건강보험공단의 요양급여비용 환수과정에 있어서 법적용 정밀성에 관한 검토 -특히 임의비급여를 중심으로-)

  • Song, Myung-Ho
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.45-72
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    • 2012
  • The National Health Insurance Corporation has been retrieving from health care providers the payments made to them by insured patients as a result of the health care providers' arbitrary denial of coverage under the National Health Insurance, and has been disbursing such retrieved monies back to the patients, pursuant to Article 57, Sections 1 and 4 of the National Health Insurance Act. However, such practice is an application of the law that lacks legal exactitude. Another problem with such practice is that there is no legal provision under any laws or notices that expressly prohibits arbitrary denial of coverage. A legislative solution, therefore, is called for to address these issues.

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Is a New Public Medical School Linked to Compulsory Service Necessary to Strengthen Public Health Care in Korea?: Who Wants to Build a New Public Medical School Linked to Compulsory Service? And Why? (우리나라 공공의료 강화를 위해 공공의대는 꼭 필요한가?: 누가, 왜 공공의대를 만들려 하는가?)

  • Han, Hee Chul
    • Korean Medical Education Review
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    • v.24 no.1
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    • pp.18-34
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    • 2022
  • The purpose of this study is to clarify the background of the controversial attempt to establish a new public medical school linked to compulsory service as a means of strengthening public healthcare in Korea, and to raise anticipated problems with possible solutions. In Korea, healthcare is predominantly provided by the private sector focused on medical care, rather than public healthcare, even under the national health insurance system. The government has been mainly in charge of public health and unmet medical services from a residual perspective, but health inequalities still exist. To resolve this issue, the government created the concept of public health and medical service (PHMS) from a universal perspective and tried to strengthen the infrastructure of public healthcare and to foster core PHMS doctors by establishing a new public medical school linked to compulsory service in medically vulnerable areas. This study investigated the reality and concept of the new public medical school planned by the government, and identified problems such as the possibility of obtaining accreditation and evaluation before its establishment, the side effects of dividing doctors' roles, the waste of huge amounts of resources, and insensitive policies. In conclusion, in order to resolve health inequalities in Korea, we need to train doctors through medical school education that strengthens the social responsibility of doctors along with strengthening public healthcare infrastructure, and to provide a better environment for doctors working in medically vulnerable areas through sophisticated policies.

2018 Current Health Expenditures and National Health Accounts in Korea (2018년 경상의료비 및 국민보건계정)

  • Jeong, Hyoung-Sun;Shin, Jeong-Woo;Moon, Sung-Woong;Choi, Ji-Sook;Kim, Heenyun
    • Health Policy and Management
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    • v.29 no.2
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    • pp.206-219
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    • 2019
  • This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2018 constructed according to the SHA2011, which is a manual for System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analyzing health accounts of OECD member countries. Particularly, scale and trends of the total CHE financing as well as public-private mix are parsed in depth. In the case of private financing, estimation of total expenditures for (revenues by) provider groups (HP) is made from both survey on the benefit coverage rate of National Health Insurance (by National Health Insurance Service) and Economic Census and Service Industry Census (by National Statistical Office); and other pieces of information from Korean Health Panel Study, etc. are supplementarily used to allocate those totals into functional classifications. CHE was 144.4 trillion won in 2018, which accounts for 8.1% of Korea's gross domestic product (GDP). It was a big increase of 12.8 trillion won, or 9.7%, from the previous year. GDP share of Korean CHE has already been close to the average of OECD member countries. Government and compulsory schemes' share (or public share), 59.8% of the CHE in 2018, is much lower than the OECD average of 73.6%. 'Transfers from government domestic revenue' share of total revenue of health financing was 16.9% in Korea, lower than the other social insurance countries. When it comes to 'compulsory contributory health financing schemes,' 'transfers from government domestic revenue' share of 13.5% was again much lower compared to Japan (43.0%) and Belgium (30.1%) with social insurance scheme.

A Study on the Recent Changes of Level of Club Cover in P & I Insurance (P & I 보험의 보상한도에 관한 고찰 - 최근의 변화 및 쟁점을 중심으로 -)

  • Shin, Gun-Hoon
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.22
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    • pp.201-226
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    • 2004
  • P & I Clubs are mutual and non-profit making insurers which offer shipowners cover for the contractual and third-party liabilities. Whereas most shipowners obtain P & I insurance to cover for their legal liabilities, they also obtain hull insurance to cover against damages to the hull of their vessels from commercial hull insurers. P & I insurance was distinguished from hull insurance in respect that it offered non-limited cover to shipowner member, but there was a serious debate between P & I Clubs in respect of the non-limited cover. A compromise by International Group of P & I Clubs eventually emerged under which, with effect from 20 February 1997, a financial cap was placed on the obligation of each shipowner to pay catasrophe calls to his club(20% of each ship's property limitation fund under 1976 Limitation Convention). Nevertheless many shipowners felt that this new cap on their potential catastrophe call had been set still too high, while others resisted any reduction in the figure established by the compromise. In the Meantime, the European Commission issued a Statement of Objections in June 1997, in which it indicated its objections with a compulsory single limit common th all the Group clubs as high as the 1997 compromise. Eventually the board of all the Group clubs decided that the figure of 20% of the Limitation Convention per ship property funds should be dropped down to 2.5% from 20 February 1999.

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2015 National Health Accounts and Current Health Expenditures in Korea (2015년 국민보건계정과 경상의료비)

  • Jeong, Hyoung-Sun;Shin, Jeong-Woo
    • Health Policy and Management
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    • v.27 no.3
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    • pp.199-210
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    • 2017
  • Background: This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 2015 constructed according to the SHA2011, which is a new manual of System of Health Accounts (SHA) that was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. Comparison is made with international trends by collecting and analysing health accounts of OECD member countries. Particularly, financing public-private mix is parsed in depth using SHA data of both HF as financing schemes as well as FS (financing source) as their revenue types. Methods: Data sources such as Health Insurance Review and Assessment Service's publications of both motor insurance and drugs are newly used to construct the 2015 National Health Accounts. In the case of private financing, an estimation of total expenditures for revenues by provider groups is made from the Economic Census data; and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. Results: CHE was 115.2 trillion won in 2015, which accounts for 7.4 percent of Korea's gross domestic product. It was a big increase of 9.3 trillion won, 8.8 percent, from the previous year. Government and compulsory schemes's share (or public share) of 56.4% of the CHE in 2015 was much lower than the OECD average of 72.6%. 'Transfers from government domestic revenue' share of total revenue of HF was 17.8% in Korea, lower than the other contribution-based countries. When it comes to 'compulsory contributory health financing schemes,' 'Transfers from government domestic revenue' share of 14.9% was again much lower compared to Japan (44.7%) and Belgium (34.8%) as contribution-based countries. Conclusion: Considering relatively lower public financing share in the inpatient care as well as overall low public financing share of total CHE, priorities in health insurance coverage need to be repositioned among inpatient care, outpatient care and drugs.