건강보험 요양기관 당연지정제도 이후의 의료체계 조명

Abstract

The Constitutional Court of the Republic of Korea has been in the process of adjudicating the constitutionality of mandatory regulation of the National Health Insurance Act since August of 2000. The regulation has designated all hospitals and clinics in Korea to take care of the enrollees of National Health Insurance Program(NHIP). If the Court judges that the regulation is unconstitutional, one may have a question how the health care system of Korea will change after the abolishment of mandatory designation. This article compared the mandatory designation of Korea with cases of many countries and tried to catch some critical points which generate problems in Korean health care system Most of countries let health care organizations to contract with insurer, so we realized that such a mandatory designation in Korea restricted the autonomy of private health care organizations and deprived the right of patients apos; choosing hospitals or clinics. We also tried to forecast the future changes after the abolishment of the regulation. There are relationships to consider among insurer, health care organizations, and enrollees. The major change will arise between insurer and health care organizations. Medical doctors or hospitals may decide whether to contract with insurer or not. We estimate that most of health care organizations will contract with the sole, biggest insurer in the environment of NHIP system and survey of medical doctors supports our guess. Attention also should be paid on the difference of quality between NHIP-contracted and non-contracted health care organizations. Non-contracted hospitals and clinics are believed to raise fee and to focus on providing more comfortable services. It will totally depend upon patient apos;s preference whether to take care at the non-contracted or NHIP-contracted. Another possibility of change may occur in the relationship between NHIP enrollees and insurer. Korean people can have a choice between NHIP and private health insurance program. This kind of change has never been in any country in the world. So it is extremely hard to guess what will happen until now. We hope further researches and discussions will enlighten the future of Korean health care system.