Since the integration of the Korean health insurance system, the value orientation towards fairness has been significantly improved. After that, the value orientation of fairness runs through the reform of health insurance, both in the payment methods and design of benefits. In terms of payment methods, due to the large income gap between residents and the relatively low burden of employees, the government strives to design more scientific payment methods to make the payment level of employees and residents more balanced. In terms of the design of the benefit system, although the object the system reform is to realize "no burden on the national medical expenses", however, from the overall performance of the policy, the level of health insurance security of Korean health insurance system is at the upper end of OECD countries in terms of the four serious diseases and catastrophic medical expenses. As to the benefits, the level of health insurance security for residents, especially low-income residents, is higher. Based on this, this study explores the system design, reform measures and system performance of health insurance in South Korea, and analyzes its fairness to provide a reference for promoting the high-quality development of basic medical security in China.
Key words
Korean health insurance /
fairness /
benefit system /
payment method
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References
[1] 韩国健康保险公团官网.健康保险适用对象[EB/OL](2023-04-21).https://www.nhis.or.kr/nhis/policy/wbhada01700m01.do.
[2] WHITEHEAD M.The concepts and principles of equity and health[J].International journal of health services, 1992, 22(3): 429-445.
[3] PANNARUNOTHAI S, MILLS A.The poor pay more: health-related inequality in Thailand[J].Social science & medicine, 1997, 44(12): 1781-1790.
[4] CASTRO-LEAL F, DAYTON J, DEMERY L.Public spending on health care in Africa: do the poor benefit?[J].Bulletin of the World health Organization, 2000, 78(1): 66-74.
[5] GWATKIN D R, BHUIYA A, VICTORA C G.Making health systems more equitable[J].The Lancet, 2004, 364(9441): 1273-1280.
[6] 周钦,田森,潘杰.均等下的不公——城镇居民基本医疗保险受益公平性的理论与实证研究[J].经济研究,2016,51(06):172-185.
[7] 王延中,龙玉其,江翠萍,等.中国社会保障收入再分配效应研究——以社会保险为例[J].经济研究,2016,51(02):4-15+41.
[8] 徐南奎,安淑智.依照收入水平划分健康保险费的适当性分析[J].韩国社会政策,2021,28(1):265-288.
[9] 郑创龙,文勇毕.健康保险费率征缴体系改革评价及发展方向[J].社会保障研究,2017,33(3):223-251.
[10] 李尚广.社会法[M].博英社出版社,2002.
[11] 郑创龙,权革创,南载旭.韩国健康保险费率负担的公平性研究[J].社会保障研究,2014,30(2):317-344.
[12] 孙栋国,车艺林.OECD国家老人保险费负担制度比较研究研究[R].健康保险研究院报告,2020.
[13] 赵明友,金旺白,朴钟植.2010年国民健康保险参保家庭的资产调查[R].延世大学产学协力团,国民健康保险工团,2010.
[14] 申英锡,林婉燮.健康保险基金运行体系发展方案[R].国民健康保险工团·韩国保健社会研究院,2011.
[15] 洪白义,白智英,朴敏希,等.国民健康保险的职工、居民参保人的缴费负担公平性分析[J].韩国社会政策,2012,19(1):199-231.
[16] 徐韩期.首尔联合新闻[N].(2019-03-07)[2023-04-21].https://blog.naver.com/rgb09/221482204678.
[17] 边德浩.资产年收入超过3400万元以上的高收入居民超过23万.每日经济[N].(2021-11-09)[2023-04-21].https://www.mk.co.kr/news/economy/view/2021/11/1059033/?utm_source=naver&utm_medium=newsstand&fbclid=IwAR0PCOCpMp-Fr_B3hCP-n-3UdF3kiJn_wb0bgoLZRXEdErh1fvyEoyLdoCk.
[18] 郑功成.“十四五”时期中国医疗保障制度的发展思路与重点任务[J].中国人民大学学报,2020,34(05):2-14.
[19] 李珍,蒋浩琛.参保机制视域下韩国国民健康保险制度嬗变及其借鉴[J].社会保障评论,2021,5(01):78-89.
[20] 朱坤,张小娟,朱大伟.整合城乡居民基本医疗保险制度筹资政策分析——基于公平性视角[J].中国卫生政策研究,2018,11(03):46-50.
[21] 仇雨临,王昭茜.我国医疗保险制度发展四十年:进程、经验与展望[J].华中师范大学学报(人文社会科学版),2019,58(01):23-30.
[22] 顾海.统筹城乡医保制度、与收入相关的医疗服务利用和健康不平等[J].社会科学辑刊,2019,No.241(02):88-97.
[23] 关博.“十四五”时期“全民医保”的风险挑战与改革路径[J].宏观经济管理,2021,449(03):41-45+53.