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남상요,권오주,김영재,西山孝之,岡本悅司,工藤 高,李?,강주현 대한의사협회 의료정책연구소 2010 대한의사협회 의료정책연구소 연구보고서 Vol.- No.-
The purpose of this study aims that 1) to study the situation of the Japanese health insurance systems and reimbursement system, 2) to study the health insurance fee through translation of the Japanese health insurance reimbursement fee, 3) to study the situation of the revision of japanese health insurance fee and its implications for Korea. To achieve the study goal, two groups of specialist was organized. One is Japanese specialist of health insurance the other one is Korean specialist. Japanese researchers divided duties according to their specialty. Korean researcher translated the code book of Japanese health insurance fee. The results are as follows: In 1961 the Japanese achieved national coverage of health insurance. The system consists of two major pillars: The Employees" Health Insurance(EHI) that covers employed working population and their dependent family members and The National Health Insurance(NHI) that covers non-employed population. The Employees" Health Insurance is further divided into Health Insurance Societies that are established in major corporations and the Social Insurance Agency that covers employees and medium to small sized corporations. In 2008, the health insurance system was radically restructured. The elderly population aged 75 years or older was separated and covered by the newly created the Health Insurance System for the Old-old. The reimbursement is basically fee-for-service and the government sets the national uniform fee schedule as well as the price list of all drugs covered by insurance. The fee schedule is revised every two years through the negotiation between the government and the provider side as Japan Medical Association etc. The fee schedule revision is important in health policy making because not only it changes the price but also it implements certain health policy. The implications of this study shows as follows: 1) Treatment fee between hospital and clinic must be control to achieve health care delivery system. 2) To develope preventive service items for preventing disease. 3) Strengthen the pediatric fee for service to invigorate pediatric service for children. 4) To develope the item of disease management fee for chronic disease patients.
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