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RISS 인기검색어
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- 저자 : 이충섭 ( Choong Sup Lee ) (검색결과 3 건)
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의료보험(醫療保險)의 상반(相反)된 선택(選擇), 도덕적(道德的) 위해(危害) 및 본인부담제(本人負擔制)의 이논적고찰(理論的考察)
이충섭 ( Choong-sup Lee ) 한국보건사회연구원 1989 保健社會硏究 Vol.9 No.1
As George Akerlof pointed out in his brilliant study of the used car market, informational asymmetry can lead to certain types of market failure. In this paper, I examine two cases in which informational asymmetry could interfere with the operation of health insurance markets. One is the case of adverse selection, in which the insurer cannot determine some character-istics of the insured that are relevant to the determination of the probability of the future state of nature. I show that ``extreme`` adverse selection could lead to the collapse of health insurance markets. The other case is moral hazard which refers here to the tendency of insurance protection to alter an individual`s motive to prevent loss;in other words, the insured has the power and ince-ntive to change the present slate of nature. I also show that competitive equilibrium under moral hazard could lead individuals to overconsume insurance and under-consume loss prevention. I suggest that compulsory public insurance may produce an improvement over the market outcome. Coinsurance scheme may be one of optimal solutions in this kind of moral hazard situation. But I also show that the rising coinsurance rate could produce the undesirable outcome that it decreases ·the demand of poor class severer than that of rich class.
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강길원 ( Gil Won Kang ),이충섭 ( Choong Sup Lee ) 한국보건행정학회 2007 보건행정학회지 Vol.17 No.3
Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce ``resource based relative value scales(RBRVSs)`` like USA, but political adjustment of RBRVS studied in 1997 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical depart?ments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department. This project failed in making ``resource based`` relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician`s work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.
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고형철 ( Hyung Chul Koh ),이충섭 ( Choong Sup Lee ),하성용 ( Seong Yong Ha ),최희문 ( Whee Moon Choi ),임지원 ( Ji Won Rhim ),남상용 ( Sang Yong Nam ) 한국공업화학회 2011 공업화학전망 Vol.14 No.3
압축공기 중의 수분은 공압설비의 모든 요소에 중대한 해를 입히며 밸브의 고착, 계기의 막힘 또는 공압기기의 오작동을 일으키며 생산하는 제품의 질에 있어서도 많은 해를 입혀서 제품의 질을 떨어뜨리는 역할을 하게 된다. 따라서 수분을 제거하는 방법이 필요하며 기존의 냉동식 및 흡착식을 대신하여 분리막 법이 적용될 수 있다. 현재 제습용 기체분리막 모듈은 적용이 시작된 단계에 있다. 제습용 기체분리막은 의료기기, 분석기기, Instrument air 장비에 응용이 진행되고 있다. 최근 들어 선진각국 뿐만 아니라 국내에서도 막소재 개발, 복합막 개발, 모듈 개발, 시스템 설계 및 제작 기술 개발이 진행되고 있다. 현재로서는 제습막공정에 적합한 막소재의 개발이 시급하지만 이후 적용확대를 위해서는 제습용 기체분리막의 신뢰성 향상을 위한 다각도의 노력이 필요하다.
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