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정부 건강보험 보장성 확대방안의 쟁점과 과제

작성자
의료정책연구소
작성일
2018-10-30 16:24
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정부 건강보험 보장성 확대방안의 쟁점과 과제

연구자 : 김계현, 김한나
학술지 : 법과정책 제24집 제2호
발행처 : 제주대학교 법과정책연구원
발행년도 : 2018

【차 례】
Ⅰ. 서론
Ⅱ. 정부 건강보험 보장성 확대방안의 주요 내용
Ⅲ. 정부 건강보험 보장성 확대방안의 쟁점
Ⅳ. 건강보험 보장성 확대를 위한 개선과제
Ⅴ. 결론

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.