KJC Korea
Journal Central

This study aims to examine the impact of change in population structure, i.e., populationaging, on health care expenditures. Analysis was conducted with data onnumber of enrollees, visit days, expenditures of entire beneficiaries of the NationalHealth Insurance(NHI), 2003-2012. Examination of expenditure profile by age group reveals that health care resourcesare allocated more for older population over time, suggesting significant growth ofhealth care expenditures due to population aging. However, results from decompositionmethod, which measures the contribution of each component to increaseof health care expenditures, presents that population aging contributes about only20.9 percent and the increase is ascribed largely to other components rather thandemographic factor, in particular price factor. Analysis of cohort by 5-year agegroup demonstrates that price factor is significant determinant of health care expendituresacross age group. Findings from this study suggest that population agingis not the main component of growth of NHI expenditures 2003-2012 and pricefactors related to change of coverage and practice of provider should be consideredin this regard.

This study addressed two differential cost-sharing polices in July 2009 and October2011 to check whether outpatients were affected by the policies in using healthcare services and to draw out implications for establishing more efficient medicalcare delivery system by easing the tendency towards big hospitals. In 2009, theco-payment rate for outpatients at tertiary care hospital was increased. In 2011, theco-payment rate for pharmaceutical services were increased when people get drugprescriptions at general hospital and tertiary care hospital for treating 52 specificdiseases. The study result showed that ‘time-after 2009 policy’, ‘the implementation of 2011policy’, and ‘time-after 2011 policy’ factors had impacts on reducing the number ofoutpatients and the amount of outpatients’medical expenses in tertiary carehospital. However, these policies were not appeared to be effective in increasingthe numbers of outpatients and the amount of medical expanses in clinics andhospitals. Based on this study, it’s not clear that decreased utilization of tertiary care hospitaland general hospital through co-payment polices has been converted to demandfor the small hospitals and clinics. These results imply that price policy such as differential cost-sharing intended to alter behaviors of demand side of health careservice has limited effect on functionalizing the level of medical institutions. Important implications for Korea from the study are two-folds. First, what we needmay not be the government’s leading role in increasing part-time work opportunitiesfor most women, but rather, common efforts by workers and employers togetherwith the entire society in deciding the future direction of the society modelwe want to pursue in the long run. Moreover, what types of roles women will beexpected to play in the future Korean society must also be decided upon. Therefore, not only labour policies, but also women, family, and welfare policiesshould be considered all together in harmony.

This study aims to analyze class structure and precarious work in Korean serviceeconomy. Literature on precarious work focused mainly on employment insecurityof atypical workers. This approach neglects the multi-dimension of precariousnessand also overlooks on the dynamics within the atypical employment. This studyconcretize precariousness into insecurity in employment, income and socialprotection, and also includes wage workers, non-wage workers, unemployed andpotential unemployed in the analysis. Regarding the waged and non-wagedworkers, the paper investigates on which class is more exposed to precariousness,and the size of total precarious workers are investigated by including unemployedand potential unemployed. The result suggests that service workers andproduction workers are constantly exposed to precarious work, with a more riskfor service workers. Also the size of precariat in 2010 is 43-50% in Korea. Especially for service workers, workers are not only more exposed to employmentand income insecurity but they are also structurally excluded from traditionalsocial protection system suggesting a need for development of alternative socialprotection system for these workers in Korea.

This article examines what difference the functional criteria of disability based on the ICF make tothe probability of disabled people’s being employed, relative to the medical criteria based on theICD which are currently used in Korea. Using the Panel Survey of Employment for the Disabled,this article conducts probit and other analyses of the effect of functional disability on the probabilityof employment against medical disability. The result shows that functionally disabled peopleare much less likely to be employed in the competitive labor market than are medically but notnecessarily functionally disabled people. This suggests that there is a wide gap between the functionaland medical criteria of disability. In light of this result, this article makes a case for a transition from the medical to functional criteria of disability in the implementation of disability employmentpolicies in Korea.

Social Integration has been an important issue in the Korean society as conflict anddisintegration become more severe problem in these days. This article reviews previousconcepts and theories of social integration, clarifying related concepts andproviding coherent logics of social integration. Utilizing theories of economic and political institutions and social quality, this articleconceptualizes social integration as a ratio of potential conflicts and integrativecapacity. Under this conceptualization, it is an arduous task for a society which hashigh potential conflicts and low integrative capacity to achieve social integration. On the other hand, a society with higher integrative capacity would maintain socialharmony despite high potential conflicts. Potential conflicts are measured as thesum of economic inequality, distrust, and disparity in value orientation. Next, socialintegration capacity was measured as the sum of system capacity, lifeworld capacity,and societal moral capacity. Here system capacity is composed of the governmentexpenditure on public educationa and welfare, life-world capacity as thesum of freedom of press, gender empowerment, voter turnout, and democracy. Transparency was the measure for moral resources. Calculation of social integration index using empirical data shows that Korearanked 40th among total 86 countries. Following profile analysis finds that distrustand ideological ․ cultural skewness are main sources of conflicts in Korea. It also reflectsthat Korea is lagging behind in political and social empowerment. It also revealsthat more transparency is needed to be more integrated and harmonizedsociety. The empirical analysis shows that there should be two contrasting approaches formore social integration: ‘Tight coupling’ of norms and real application is requiredfor institutions related to public rules, whereas ‘loose coupling’ is necessary in educational,cultural and industrial areas where individuals’ autonomy and creativityplay essential role.

This article tries to explain the retrenchment of universal pension OAS in canadathrough change of party competition structure and blame avoidance strategy. Asstate debt and deficit increased, The conservative party and liberal party stopedthe politics of welfare expansion and played the politics of welfare retrenchmentcompetitively. First, the try of conservative party to introduce the partialde-indexation on OAS benefit was failed by popular opposition. The reasonconservative party fail was contributed to social democratic lined 'new democraticparty(NDP)' opposition with liberal party to the ruling party's effort to reduce OASbenefit and to lacking of politically technical arrangments to mitigate an oppositionthough the partial de-indexation on OAS benefit were very visible action to applythe elderly of OAS recipients in canada. But the second try of conservative partyto clawback benefits from OAS were introduced successfully. The reason ofconservative party's powerful drives and success was contributed to positiveconfrontation to the rising of extremely right lined 'reform party' demanded theend of universality, and to politically technical arrangements to mitigate anddisperse an opposition, making pension system selectively and complicatelythrough pension benefit linkaged tax system. The liberal party that came to power in 10 years proposed tax-exempted and family income-tested ‘Senior’s Benefit’, combining OAS and GIS for reduced budgetand deficit similiar with conservative party. Senior’s Benefit ran into strong criticismfrom the left and right of political spectrum, and the reform eventually waswithdrawn in late July of 1998 though it was progressive style and liberalgovernment made efforts to minimize an political backlash. Getting encouragedwith the fall of NDP and conservative party, liberal government attempted so-called‘centrist’ policy but received attack for demise of universality from left pary andexessiveness of progressity from right. For understanding liberal government’ failureof introducing Senior’s Benefit, considering timing condition of improved financialsituation and expected budget balancing was necessary except for party competitionstrucuture and political technicque.

Since the introduction of Trade-related Aspects of Intellectual Property Rights(TRIPs)in 1995, comprehensive and strict standards for patent on pharmaceuticals havebeen generally applied to all WTO member countries. Furthermore, other bilateralor multilateral trade agreements, in which stronger protection of intellectual propertyright is guaranteed than in TRIPs, have been exacerbating the monopoly ofpharmaceutical market. However, there are considerable controversies over whetherstrengthening intellectual property rights for pharmaceuticals would contribute to theimprovement of public health, and there are limited empirical studies over thisissue. This study tries to examine the effects of stronger protection of intellectualproperty rights for medicines, using the cases of five countries: Jordan, India,Mexico, Australia and South Korea, specifically focusing on each country's changein pharmaceutical market structure, price and utilisation of medicines. Our studyshowed that all five countries were forced to implement stronger protection ofintellectual property rights as the result of trade agreement with other countries andthese policy changes affected domestic pharmaceutical market with the level ofpharmaceutical price, even though they had quite different history of the development of pharmaceutical industry and health care policies before the policychange. In addition, each country adopted different coping strategies to deal withthe change of pharmaceutical market, which emerged from the stronger patentprotection.