http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : 사사다 시호 (검색결과 1 건)
- 무료
- 기관 내 무료
- 유료
-
한.일간의 의료보험 관리 운영에 관한 비교연구(도입초부터 1993년까지)
남은우,사사다 시호 高神大學校保健科學硏究所 1997 보건과학연구소보 Vol.7 No.-
This paper aims to clarify two nations health insurance systim with some data. The data for pre-period to 1993. The people of the Republic of Korea have benefitde from universal health insurance coverage since 1989. The rapid expansion in the coverage of the social health insurance systim was due in large part to favourble economic circumstances combined with explicit govermment policy. The curent of the systim is a far cry from the harsh reality that prevailed in the early 1960s, the Republic of KAorea was a poor, agrariancountry in which seasonal famine was a serious problem. The roots of the country's present-day health insurance system can be found in the policies of the authoritariian military govermment which took power after a coup in 1961. In that after, changing circumstances would soon make compulsory health insurance a more viable proposition. Powerful economic developnent between 1962 and 1976 transformed the country from a predominantly agrarian society to a rapidly expanding manufacturing and industry-based economy. Per capita GNP had risen to US $765 by 1976. Resing income and employment in the manufacturing sector paved the way the introduction of compulsory health insurance for industrial workers. The first compulsory system, which covered the personnel in companies with more than 500 workers, was introduced in 1977. The system was financed by contributions paid by workers and their employers, and was administered by independent health insurance societies which were established by cach company. Continres rapid industrialization in the 1980s further increased employment and incomes in the industrial sector, and the economy grew by an average of more than 10% annually between 1980 and 1988. The consumer price index had remained relatively stable during the same period, and the govermment budget showed a financial surplus of 1.4% in 1986. The main lesson learnt during this process is that rapid economic development creates favourable socioeconomic conditions for the expansion of coverage to all industrial worders and government employees. It is clear that political action and government support are further key factors in the establishment of a veable and equitable health insurance systim. This experience also demonstrates that contribution-sharing on the farmers and the self-employed are to benefit from compulsory health insurance in Korea. Japan's health care system balances universal coverage at reasonable coat. The ratio of the GDP devoted to health care is 6.8% in 1990. Meanwhile Japan has achieved the longest life expectancy and the lowest infant mortaliyt in the world. Since Korea patterned after the Jpaan's compulsory insurance system, the health financing system is quite similar and Japan has a strong private sector as well which consists 82% of hospitals and 94% of clinics in 1992. In contrast to basically laissez-faire policy taken toward the delivery system, the financing system is heghly regulated in Japan. Every citizen must join one statutory health insurance plan offerde by their employer, or if they are self-employed that akminstrated bytheir local government. Since achieving the universal coverage of health insurance in 1961, the government. Since achieving the universal coverage of health insurance in 1961, the government decreased copayment rates for selt-employed and dependents from 50% to 30%. Although copayment rates are different from 10% to 30% among plans, all plans offer the same set of comprehensive medical benefits. Premiums amount to only 4% the average employee's total income in 1991. The government has a strong incentive to contain the growth of total health expenditure because the government subsidises one of health insurance plan(for self-employed) at a fixed rate. The fee schedule is annually reviewed by the Ministry of Health. From 1981 to 1990, drug price and laboratrory test fee, which used to give much profit for hospitals, have decreased by 52%. Thus the net increase for fees was kept at only 2.4%, while increase in inflation was 15% during the same period. This control has in dffect set an implicit global budget. It is worth recognezing that Japan's economic growht may have masked the sharp increase in health care coats. In Japan medical coats are relatively low and copayment is not much burden on most patients. However, it has some serious problems. Most serious feature has to do with quality of care. No real incentives exist to maintain quality. As a result of patients are increasingoy turing to the university and large public hospitals, there long queues for ortpatient visits. Development of referral system would be one solution, byt clinics and hospitals have regarded eachg other as competitors. Information disclosure and a formal system of extemal audit might be necessary.
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
