건강보험에서 적용 가능한 세대 간 형평성개념과 모형 시뮬레이션 결과의 정책적 함의 = The Possible Concepts and models for Intergenerational Equity of the National Health Insurance and its Simulations Results

다국어 초록 (Multilingual Abstract)

The intergenerational equity problem in the National Health Insurance can threat its sustainability itself. Therefore it is important to know the possible intergenerational equity concepts and to investigate the possible policy instruments. Two standards for the intergenerational equity are chosen to study the policy instruments for the improvement of the intergenerational equity in the National Health Insurance. The first is the minimizing the sum of the absolute value of the net transfer deviations from the zero(Trans-Min). That the net transfer E(t)=0 means actuarial fairness. The second is to minimize the maximum net transfer(Minimax). Who makes the maximum net transfer is the weakest Therefore to minimize the maximum net transfer is the Rawlsian Principle, i.e. the protection of the weakest. Two major policy instruments are the accumulation of funds and the ca-sharing of the cost This simulation study shows the following results. Firstly, the introduction of cost-sharing improves the intergenerational equity situation. Secondly, the Trans-Mm has the tendency to lead intergenerational net transfer E(t) to zero. The variable cost-sharing policy has the stronger effects than the constant cost-sharing policy. Thirdly, the Minimax improves the weakest position without the change of the relative position. In addition to that it makes the differences between the weakest position and the other positions closer. The variable cost-sharing policy has the stronger effects than the constant cost-sharing policy. Fourthly, the accumulation of funds improves the intergenerational equity remarkably by the Trans-Min.

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