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The following is a general assumption.
Health care systems in which specialist (i.e. MD's in specific practice areas) and hospital care are accessible ONLY after obtaining a referral from general practitioners (GP) have LOWER total health care costs.
In a recent seminar, Professor Kim Yang-kyun of Kyunghee University said the government should introduce a two-way referral system in health care delivery, to bring forth more efficiency.
The proposed two-way referral system in health care delivery is a working relationship between a primary health care provider (or facility) and a high-tier hospital (or facility) at the time of transfer and discharge of a patient.
Individuals should be limited to certain medical facilities (i.e. tier-wise) which accept the particular type of medical insurance they carry, according to Professor Kim.
Kim said that patient visits to medical facilities outside the insurance program's "network" are usually not covered, and the patient must bear more of the cost.
He also commented that hospitals should negotiate with insurance programs to set reimbursement rates (some rates for government insurance programs are set by law).
In Japan, medical services are provided either through regional/national public hospitals or through private hospitals/clinics. Patients have universal access to any facilities, though hospitals tend to charge higher for those without a referral.
Public health insurance covers most citizens/residents and pays 70% or more cost for each care, and each prescribed drug. Patients are responsible for the remainder (upper limits apply). The monthly insurance premium is 0-50,000 Japanese Yen per household (scaled to annual income).
Supplementary private health insurance is available only to cover the co-payments or non-covered costs, and usually makes a fixed payment per days in hospital or per surgery performed, rather than per actual expenditure.
In 2005, Japan spent 8.2% of GDP on health care, or US$2,908 per capita. Of that, approximately 83% was government expenditure.
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- 입력 2010.08.24 08:40 수정 2010.08.24 11:47
The following is a general assumption.
Health care systems in which specialist (i.e. MD's in specific practice areas) and hospital care are accessible ONLY after obtaining a referral from general practitioners (GP) have LOWER total health care costs.
In a recent seminar, Professor Kim Yang-kyun of Kyunghee University said the government should introduce a two-way referral system in health care delivery, to bring forth more efficiency.
The proposed two-way referral system in health care delivery is a working relationship between a primary health care provider (or facility) and a high-tier hospital (or facility) at the time of transfer and discharge of a patient.
Individuals should be limited to certain medical facilities (i.e. tier-wise) which accept the particular type of medical insurance they carry, according to Professor Kim.
Kim said that patient visits to medical facilities outside the insurance program's "network" are usually not covered, and the patient must bear more of the cost.
He also commented that hospitals should negotiate with insurance programs to set reimbursement rates (some rates for government insurance programs are set by law).
In Japan, medical services are provided either through regional/national public hospitals or through private hospitals/clinics. Patients have universal access to any facilities, though hospitals tend to charge higher for those without a referral.
Public health insurance covers most citizens/residents and pays 70% or more cost for each care, and each prescribed drug. Patients are responsible for the remainder (upper limits apply). The monthly insurance premium is 0-50,000 Japanese Yen per household (scaled to annual income).
Supplementary private health insurance is available only to cover the co-payments or non-covered costs, and usually makes a fixed payment per days in hospital or per surgery performed, rather than per actual expenditure.
In 2005, Japan spent 8.2% of GDP on health care, or US$2,908 per capita. Of that, approximately 83% was government expenditure.
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