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Legal Consideration of the Characteristics and Limitations of Korea’s Health Care System

  • Legal Theory & Practice Review
  • Abbr : LTPR
  • 2024, 12(1), pp.127-159
  • Publisher : The Korea Society for Legal Theory and Practice Inc.
  • Research Area : Social Science > Law
  • Received : February 13, 2024
  • Accepted : February 24, 2023
  • Published : February 29, 2024

Kim, Won-Il 1

1이화여자대학교

Accredited

ABSTRACT

In order to cope with changes in the healthcare paradigm, such as population aging, changes in disease structure to chronic diseases, and public health crises, the following improvements to the national healthcare system are necessary. First, the shortage of health care personnel, such as doctors and nurses, must be increased. However, simply adjusting quantitative aspects alone does not solve the imbalance in the supply of health and medical manpower in our country. Above all, state responsibility must be expanded and strengthened. Recently, the government announced an increase in medical school enrollment by 2,000 students. However, quantitative expansion alone cannot address the health care needs of the community and citizens; it only meets the necessary conditions. The ultimate reason for the state to intervene in the market is that if left to the market, resources will not be distributed efficiently to areas in need. In particular, in the reality in our country where there is no state responsibility for training health and medical personnel, doctors cannot be efficiently distributed to regions and fields in need without government intervention. Therefore, in order to efficiently distribute medical manpower, the state must contribute to the training of doctors through free education and, based on that contribution, deploy doctors to essential medical fields and regional medical services. Second, the overall size of hospital beds should be reduced, but general hospital-level medical institutions with more than 300 beds that provide essential medical care should be expanded. A regional bed capacity system should be introduced, and the number of beds concentrated in small and medium-sized medical institutions should be minimized or their function conversion should be encouraged. On the other hand, general hospital-level medical institutions with 300 or more beds to provide essential medical care must be established under the responsibility of the national or local government in each region. Through these system and policy improvements, the role and status of primary, secondary, and tertiary medical institutions must be established. Third, the fee-for-service system, which is a compensation method for health care services, must be improved. Recently, a group of doctors has advocated for an increase in medical school admissions, arguing that if the number of doctors increases, the use of medical services will increase and health insurance finances will be ruined. However, the number of doctors in Korea is the lowest among OECD countries, but the medical utilization is the highest among OECD countries because of the fee-for-service system. In a crisis situation where health insurance financial income is decreasing and expenditures are increasing due to low birth rate and aging population, insisting on only the fee-for-service system will lead to the collapse of health insurance finance. Recently, the need to transition to a value-based health care system has been raised. This is a proposed plan to efficiently respond to issues such as changes in the healthcare paradigm, that is, population aging, changes in disease structure to chronic diseases, response to infectious diseases due to climate change, etc., and national responsibility for essential medical care. In order for the characteristics and limitations of our country's health care system to change for reality and the future, comprehensive improvements to the outdated health care law system centered on 'medical institutions and doctors' must be carried out first. In a country governed by the rule of law, the only way to correct the failure of government policies regarding our country’s health care system is through ‘legislation.’ We must respond to changes in the healthcare paradigm, such as population aging, changes in disease structure, and public health crises, by improving the healthcare legal system through legislation.

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