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189) , , , 2014, 453.

190) , ,

Eleanor D. Kinney.,

"Provisions for Health and Health Care in the Constitutions of the Countries of the World",

Cornell Int'l Law. J., Vol 37, (2004), 289 .

191) 251. , . 2,

, , .

192) .

193) Art. 41 1 The Confederation and the Cantons shall, as a complement to personal

responsibility. and private initiative, endeavour to ensure that: a. everyone has access to

social security; b. everyone has access to the health care that they require.

194) Art. 32 The Republic safeguards health as a fundamental right of the individual and as a

collective interest, and guarantees free medical care to the indigent. No one may be obliged

to undergo any health treatment except under the provisions of the law. The law may not

under any circumstances violate the limits imposed by respect for the human person.

195) ARTICLE 56. Everyone has the right to live in a healthy, balanced environment. It is the

duty of the state and citizens to improve the natural environment, and to prevent

environmental pollution. To ensure that everyone leads their lives in conditions of physical

- 146 -

. 41196)

,

.

, 196197198

.197)

3.

and mental health and to secure cooperation in terms of human and material resources

through economy and increased productivity, the state shall regulate central planning and

functioning of the health services. The state shall fulfil this task by utilizing and supervising

the health and social assistance institutions, in both the public and private sectors. In order

to establish widespread health services general health insurance may be introduced by law.

196) Article 41 1. Everyone shall have the right to health protection and medical aid. Medical

aid in state and municipal health establishments shall be rendered to individuals gratis, at the

expense of the corresponding budget, insurance contributions, and other proceeds. 2. In the

Russian Federation federal programmes of protecting and strengthening the health of the

population shall be financed by the State; measures shall be adopted to develop state,

municipal and private health services; activities shall be promoted which facilitate the

strengthening of health, the development of physical culture and sport, ecological and

sanitary-epidemiological well-being.3. The concealment by officials of the facts and

circumstances posing a threat to the life and health of people shall entail responsibility

according to the federal law.

197) Eleanor D. Kinney., "Provisions for Health and Health Care in the Constitutions of the

Countries of the World", Cornell Int'l Law. J., Vol 37, (2004), 310 .

- 147 -

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PAPER, 2013,5.

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1994.6.30. 929

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1996.10.31. 947, 8-2.

2000.4.27. 9816

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2003.10.30. 2000801, 15-2

2002.10.31. 9976, 2000505()

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2003.12.18, 20021, 15-2(),

2004.10.28. 9991

2004.10.28. 2002328 98

2005.5.26. 99513 , 17-1

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(http://www.etymonline.com)

(http://www.who.int)

(http://dic.daum.net)

(http://www.bl.uk)

(http://www.un.org)

(http://www.ilo.org)

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AMA, Health System Reform Legislative Summary Chart of Major

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Abstract

Challenges and Improvement measures of National

Health Insurance Act for realization of the Right to Health

- through Constitutional Issues-

Health is a precondition to maintain community and its homogeneity by

allowing individuals to share their social and cultural values. Our

constitution recognizes health as a national matter and provides protection

indirectly based on the human dignity and the right to happiness under

Article 10, the environmental right under the first clause of Article 35 of

the Constitution, and directly based on the right to have basic standard of

human life under Article 34 and the right to health under Article 36 of the

Constitution. This task of the Constitution becomes materialized through

the National Health Insurance Act.

Health care benefits provided by the National Health Insurance Act

should be appropriate to solve health care challenges and its decision

process should be reasonable. In addition, the foundation to guarantee

health rights of citizens should be established by making the system where

people can choose health care services rationally including the uncovered

services, which are beyond the scope of the health insurance. Therefore,

the management group operating the health insurance needs to suggest

plans that can organize and operate the health insurance realizing the

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health rights of citizens and can solve challenges including the ones caused

by the uncovered services. In this respect, the current National Health

Insurance Act should solve the challenges mentioned below.

First, the benefit package that is covered by the National Health

Insurance Act cannot directly solve the health risk of citizens. Burden

caused by the uncovered services is highly likely to cause giving up of

health or the economic plight. However, the area of the uncovered services

is not only the area of the health insurance system but the area where the

contracts between the health care facilities and individuals occur, which

blocks the direct intervention by the country. Therefore, the coverage

should be extended by switching the uncovered area to the covered area

and this can be achieved by extending the range of the benefit package.

At the same time, in case of the uncovered services, providing information

on cost and effect that enable rational cost decision between patients and

health care providers will guarantee citizens right of choice for health care

services and the detailed administrative enactment is required such as

minimizing the liberty infringement of health care professional performing.

Second, the National Health Insurance Act lacks the legitimacy of formal

and procedural requirements in the cost decision process of health care

services. In terms of formality, the organization of the Health Insurance

Policy Committee which decides the cost of health insurance benefits is not

structured in a way that can obtain trust from health care professionals,

the health care providers. The current human resource of the committee is

structured in a way to represent the voice of the insurers easily and this

drops not only the trust towards the committee and but also the

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acceptability of the decision among the health care professionals. Therefore,

it is required to have the proper human resources that can equally speak

for interests of both insurers and providers. In terms of the procedure, the

Minister of Health and Welfare makes a decision through a public

announcement unless the contract for the benefit package is made between

the insurers and the providers. However, it needs further consideration on

whether there are any alternatives other than just confirming the cost, one

of the important elements of the contract, by the Minister without

settlement out of court. For example, when there is no settlement out of

court, it may be possible to apply the current cost to the following year

and make revision when the consensus becomes available through

continuous publicity.

Third, the cost should be used efficiently in order to maintain the

substantiality of the health insurance system and the rational operating

system should be prepared so that the misuse and abuse can be

minimized. In Korea, an independent institution, the Health Insurance

Review and Assessment Service (HIRA), not the insurer, performs review

and assessment of appropriateness of handling the premium. Therefore,

HIRA should secure the position that can review and assess the

appropriateness of the health care cost based on the scientific and

objective evidence with the structure independently of the insurer.

However, according to the current National Health Insurance Act, HIRA

has its structure difficult to perform review and assessment independently.

Therefore, the legislation should be improved so that it can secure its

normative independence.

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The nation should put its effort to make citizens lead a life worthy of

human dignity by actively solving their health problems. Though it may be

impossible to realize the goal in reality, it is the countrys mission to put

its maximum effort. But one of its important role is to induce the

agreement from the community by actively and rationally providing

explanation on the limitation of fundamental rights and duties of individuals

that are caused by the countrys role performance. As for the limitation of

fundamental rights, if possible, additional efforts to mitigate the limitation

range are required. The country can remain as what it really is when it

actively protects its citizens from danger. This is the reason why the

nation should protect its citizens health more actively.

Key words: Health rights, National Health Insurance Act, Health care

benefits, Uncovered services, Right of Acceptability, Right

of Accessibility to Health Care, Right of Choice, Social

Fundamental rights