Health Policy Manag.  2022 Jun;32(2):137-153. 10.4332/KJHPA.2022.32.2.137.

International Comparison of the Non-benefits Management Policies for Public and Private Health Insurance

• Kim HY
• Chang CW

• KMID: 2534958
• DOI: http://doi.org/10.4332/KJHPA.2022.32.2.137

Abstract

In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as ‘large or small,’ and the government’s regulation and management policy on private health insurance was classified as ‘strong or weak.’ Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government’s management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries’ cases.

Keyword

Public health insurance; Private health insurance; National health insurance service; Benefit coverage; Non-benefit; Universal health coverage; Coverage expansion