일반논문 : 국민건강보험의 헌법상 의미와 실현구조

The importance of health in human life can never be overemphasized. While it was widely believed in the past that maintaining and improving health was a personal duty, it is now considered to be a national priority. Along with the advancement of a social state, this new notion has become so widespread that providing proper medical service for public health is recognized as an important responsibility of each nation. While there is wide consensus around the world that medical service should be a nation`s responsibility and not a person`s, countries` approaches vary in how to provide proper medical service. For example, the British government assumes the responsibility for providing comprehensive medical service, which it directly manages and operates with resources financed by tax revenues, while other countries, such as Germany, have institutionalized social insurance. On the other hand, medical service remains a personal responsibility in some countries as in the United States before its Congress reformed the medical system. However, based on the beliefs of a social state more countries are moving toward strengthening a wide range of social insurance systems, a good example of which is the United States which recently introduced a reformed medical system that obliges its people to enroll in medical insurance programs Korea has managed its public health insurance system since it was introduced in 1977. At the beginning, little was compensated by the system, but as a result of numerous discussions and institutional reforms, the public health insurance system has evolved and its service has improved. However, there is still much room for improvement, and considering the latest developments in the industrial and demographic structures, another reform will be needed for the public health insurance program in two or three decades. Current challenges include adjusting the level of medical service and insurance premiums, building a stronger connection between the public health insurance program and private insurers, and enhancing the fairness between those paying premiums through their employers and those paying through their local administrative offices. However, there is also a long-term challenge in the next 20 to 30 years: securing stable financial sources in an age of graying population and growth without employment.