정부 건강보험 보장성 확대방안의 쟁점과 과제 = A Study of Issues and Problems: Government's Plan for Benefit Expansion in National Health Insurance

다국어 초록 (Multilingual Abstract)

President Moon directly announced the Government’s Plan for Benefit Expansion in National Health Insurance on August 7, 2017.
The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs.
Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance.
The government recently announced strengthening the plan for health insurance coverage. the purpose of this plan was to increase the coverage rate by up to 70%. The government has suggested detailed plans but there remain many controversial issues and limitations with regard to the practical aspects. Thus, further research and suggestions are needed.
This paper analyzed the main contents and problems of the government’s plan for benefit expansion in national health insurance system, and considered tasks and improvement in the future. The results of the study are as follows: In health care, the benefit coverage rate is an important issue. However, in order to increase the coverage within a limited reset, the mandatory items should be identified first. Principles and methodologies to set priorities need to be discussed and agreed with experts. In addition, the scope extension plan should also take into account the improvement of the medical delivery system and restrictions on medical use, reflecting the characteristics of Korean medical use. Finally, the improvement of the health insurance system requires a long-term financial management plan and a comprehensive plan.

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