German health insurance coverage rate 76.3%

"Even though it is necessary treatment, it will not be covered and I will not give up."

President Moon Jae - in told his patients last August. It was a declaration to announce the start of measures to strengthen health insurance protection called 'MoonJin In Care'. It is the core content of Moon Jae In Care to convert over 3,800 items of medical expenses that do not pay for cosmetics and cosmetics to health insurance benefits. The Dong-A Ilbo reporter team looked into the medical field of developed countries where most of the medical services were provided as health insurance, and looked at the future challenges of "one year of caregivers".

In Germany, even if you have a heart surgery,

"I am a family of three, and I pay about 190 euros a month for a premium."

Christophe (42), who met at the Bau Van Hospital in Paris, near Paris, on the 26th of last month. Most French people join both health insurance (private insurance) and private health insurance. In France, public insurance accounts for 78% of the total national health expenditure. Private medical insurance supports 13.5%. The personal burden is only 8.5% of the total medical expenses.

Private insurance is limited to a portion of the public health insurance premiums and dental treatment expenses not covered by public insurance. It is a supplementary means of thorough insurance. "Most of the diseases are covered by health insurance, so they do not get treatment or surgery because of the cost," said Kreb Bruno, a hospital surgeon.

Of course, France's health insurance premium rate is more than 13%, which is higher than the national health insurance premium rate (6.24% this year). If you look at health insurance alone, it seems that France is burdened with insurance costs. That's because of the difference in protection.

France's health insurance coverage rate (the percentage of the total health expenditure covered by health insurance) is close to 80%. Korea, on the other hand, is only 62.6%. In order to overcome this, it is costly to go to private insurance such as real loss insurance. The direct burden ratio of domestic medical expenses is 36.8% (2014), which is 1.9 times higher than the OECD average (20.3%).

An official from the Korea Health Insurance Corporation said, "We guarantee 63% of the health insurance, average 100,000 won per month, while paying 370% of the accident insurance, while paying 250,000 ~ 300,000 won per month. But it will reduce the burden of hospital expenses because there is no need to sign up for the accident insurance.

Germany also has a low burden on patients because of its high health insurance coverage. Daniel Kirch, 43, a Berlin citizen who met the journalist, was hospitalized for two months after heart surgery, but at the time of discharge, the hospital cost was "0 euro". It costs about 130 euros per month (about 170,000 won). On the other hand, Kim, who received a coronary artery bypass graft due to a myocardial infarction in Korea, cost more than 10 million won. He even paid 450,000 won each month for health insurance (200,000 won) and real loss insurance (250,000 won).

○ Detailed investigation of non-payment is essential

However, Moon Jae-in, a soft landing, has to overcome many difficulties. "When purchasing magnetic resonance imaging (MRI) imaging equipment at the hospital, the health department not only supports the costs but also carries out quality control," said Dr. Galoide Julie of the National Health Insurance Corporation of France. And to reduce the burden on patients. " On the other hand, the cost of purchasing high-priced equipment should be fully covered by the hospital in Korea. In the end, 'to draw the value of the device' is a structure that requires high medical fees to the patient.

The German health insurance company, 'North German Regional Insurance Association (AOK)', operates a non-pay item information homepage. Here, you can get various information such as why it is not paid, and whether the treatment effect has been verified, along with the non-payment list. AOK Henry Kortech, director of insurance policy, said, "The inspections of non-insured cataracts are also paid by insurers if necessary," he said.

In Korea, the total medical expenses of 69.4 trillion won, excluding cosmetics and cosmetics, amounted to 12.1 trillion won in non-medical expenses for the treatment of diseases. Suh Nam-kyu, a senior research fellow at the Institute of Health Insurance Policy, emphasized, "In order to reduce the medical expenses of the nation,

Transparent disclosure of medical costs is also necessary. There is a strong opposition from the medical community opposing caregiving, which is now MoonJae. When the government decides the price (number) of medical services, it is a logic that hospital is lowered if it is lower than cost and eliminates the non-payment. In Germany, the insurer group and the physician group agree on a number. It is becoming possible when the medical association transparently discloses the information of the medical center.