• 제목/요약/키워드: Compulsory Insurance

검색결과 27건 처리시간 0.018초

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

  • 김기홍
    • 한국중재학회지:중재연구
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    • 제28권4호
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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
    • 한국수학교육학회지시리즈B:순수및응용수학
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    • 제11권4호
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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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우리나라 사회보험 정책수단의 유형에 관한 연구 (A Study on the Typology of Social Insurance Policy Instruments in Korea)

  • 노시평
    • 한국컴퓨터정보학회논문지
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    • 제19권5호
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    • pp.109-117
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    • 2014
  • 본 연구는 우리나라 사회보험정책의 집행에 활용된 정책수단의 유형을 규명하기 위한 논문이다. 본 연구를 위해 지금까지 학자들에 의해서 연구된 정책수단의 개념 및 유형에 대해 살펴보았다. 이를 근거로 해서 우리나라 사회보험정책의 집행에 활용된 정책수단들의 유형을 강요적 혼합적 자발적 정책수단으로 분류하여 탐색해 보았다. 연구결과 밝혀진 사실은 다음과 같다. 첫째, 강요적 정책수단의 경우 정부보험, 공기업, 규제라는 정책수단이 모든 사회보험정책 집행과정에서 활용되었다. 둘째, 혼합된 정책수단의 경우는 강요적 정책수단의 경우와는 다른 특성을 보여주고 있다. 먼저 5대 사회보험정책 모두 사용자 부담금이라는 정책수단이 활용되고 있으나, 보조금의 경우에는 건강보험, 연금보험, 고용보험, 노인장기요양보험에서 사용되고 있다. 이러한 정책수단 외에 정보와 훈계라는 정책수단은 고용보험정책에서, 파트너십은 노인장기요양보험정책에서 활용되고 있다. 셋째, 자발적 정책수단으로는 가족과 공동체라는 정책수단이 대부분의 사회보험정책에서 활용되고 있다. 다만 산재보험정책은 공동체라는 수단만이 중요한 정책수단으로 활용되고 있는 특성을 보이고 있다.

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

  • 조형원
    • 의료법학
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    • 제8권2호
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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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건강보험 40년 성과와 과제 (Achievements and Challenges of 40th Anniversary Health Insurance)

  • 이규식
    • 보건행정학회지
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    • 제27권2호
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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.

국민건강보험공단의 요양급여비용 환수과정에 있어서 법적용 정밀성에 관한 검토 -특히 임의비급여를 중심으로- (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))

  • 송명호
    • 의료법학
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    • 제13권2호
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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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우리나라 공공의료 강화를 위해 공공의대는 꼭 필요한가?: 누가, 왜 공공의대를 만들려 하는가? (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?)

  • 한희철
    • 의학교육논단
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    • 제24권1호
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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.

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

  • 정형선;신정우;문성웅;최지숙;김희년
    • 보건행정학회지
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    • 제29권2호
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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.

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

  • 신건훈
    • 무역상무연구
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    • 제22권
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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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2015년 국민보건계정과 경상의료비 (2015 National Health Accounts and Current Health Expenditures in Korea)

  • 정형선;신정우
    • 보건행정학회지
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    • 제27권3호
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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.