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RISS 인기검색어
- 검색키워드
- 저자 : 김천산 (검색결과 2 건)
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The health insurance policy was introduced in the system of decentralization in 1997, which has individual associations as the operational unit, for the reason that it was convenient to carry out. However as the decentralization policy was operated, some problems began to appear. Unlike the original intent, problems continued to appear such as the lack of equity in charge between regional and social stratums, low pay leveling caused by severe financial unbalance between associations and inefficiency coming from management by a number of associations. Thus the separation management of the independent profit system of decentralization Administrative methods related to health insurance enlargement policy began to be reviewed for minimizing the health insurance problems in 1980. However multi-insurer administrative method was decided to be kept according to the public opinion that employee's insurance bill would increase. The health insurance administrative system was operated separately in work place centered multiple job associations and regional associations of administrational regional units. Many problems caused by low charge, low pay structure were pointed out and the government kept trying to resolve them. In order to improve the structural problems, there was a controversy on the management system of unification and decentralization. Medical insurance association, which was preexisted insurer organization, was the insurer for employees and residents. Among them, 227 regional medical insurance associations were united with public official ․ school personnel medical insurance corporation starting 1st of October 1998 by the revision bill of December 1997 and it was founded as the national health insurance corporation. 139 job medical insurance associations were united with national health insurance corporation on 1st of July 2007 and it was founded as the national health insurance corporation. In the meantime health insurance organization had been operated separately by nonprofit associations and corporations and was forced to be operated by single insurer organization, national health insurance corporation starting 1st of July 2000. However these three following questions are brought up about the simple facts. The first question is that why it took 20 years for the health insurance, which was started as decentralization in 1977, to reach the complete unification in December 1998. The second is that it can be assumed that there might have been strong influence that showed opposition to the policy change of unification even so the unification was realized against the resistance. What were the factors that contributed to overcoming the resistance from the opposing power and enabled the organizations to be united? The last question is that how the factors influence and facilitated the unification of organizations. For the answer to the first question, the intrinsic nature of the unification and decentralization needs to be examined. They had different values, so it was hard to find the interface between the two and they stood opposite each other having a divergence of opinion. In addition, political factors at the time also acted on this issue. There happened "a conspiracy of the ministry of health and society" in 1983 past the beginning of the argument on unification. The officials in the ministry of health and society and executives of medical insurance association, who advocated the unification of organization, were framed corrupt officials on and dismissed and since then the debate on the unification had been taboo. The unification bill passed the National Assembly in 1989 when the president was Roh Tae-woo, but it went to pieces because of a presidential veto. As the officials dismissed for "the conspiracy of the ministry of health and society" got to play the leading role, the agreement for the unification progressed rapidly. The answer to the second question can be divided into these following two. First the structural factor of internal organization need to be mentioned. Organizations had a conservative tendency but self-motivative demand was one factor that contributed to the unification of organizations. The next factor is environmental one. The change in politics, economy and society surrounding the organizations played a role of catalyst material for the unification. The last factor is the participants who took part in the policy decision. There was competition and conflict between the participants over the principals and methods of insurance in the process of the argument of unification. There were internal conflict factors as well as superficial factors. In other words the advocates and opponents showed conflicts from their own interests as well as complications from different valuation and it was led to the unification as the justness was given to advocators. Lastly the participants' behaviors should be examined for the third question. The advocators and the opponents showed aggressive and argumentative or defensive and passive behaviors and sometimes exercised their influence with silence. The public support for the advocators was the crucial factor that helped to overcome the opposing movements. As sympathetic atmosphere was made for the unification, the organizations partially unified and were led to complete unification and then the argument on the unification put an end. This research does not aim at telling whether right or wrong of the arguments between the advocators and the opponents but at examining the process to the unification of organizations. For the convenience of research, the process of the unification is divided into four phases of commencement, dissemination, partial unification and complete unification.
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