Research Report
Legislative Research on Korean Public Healthcare Service Law
Ⅰ. Background and Purpose
▶ Research background
○ (Purpose of legislation of the Public Health Act)
– Public health is an activity that aims to ‘guarantee the general use of medical care’, and the Public Health and Medical Services Act stipulates such matters. The 'Public Health and Medical Care Act' enacted on January 12, 2000, in the statement of reason for enactment, states, “The state or local government shall establish and operate public health and medical institutions to make efforts to meet the basic health and medical needs of the people, and to provide free loans, use, and profits from national and public properties, and public health and medical institutions to preferentially provide essential public health care, such as health care for the vulnerable, prevention and treatment of infectious diseases, and treatment of emergency patients; It declares the legislative purpose of ”. As declared in the legislative purpose of the Public Health and Medical Care Act, the starting point of public health legislation includes the conceptual element of providing 'basic health care services' mainly provided by 'public health and medical institutions' based on the responsibilities of 'public actors'. can be found
○ (State responsibility for universal medical coverage)
– Considering that the state's responsibility to ensure 'universal health care' is clearly established in the purpose of public health care, the content of medical insurance and medical equity, which are recently emerging as issues in health care policy, is presented by the state. It is necessary to review it from the legal and institutional perspective of the duties and responsibilities of public entities.
▶ Purpose of the research
○ (Goals of public health care such as medical insurance and medical equity)
–This study seeks ways to improve the public health legislation centering on public medical institutions, analyzes public health problems at the legal and institutional level, and helps to realize the goals of public health care including health insurance and health care equity. The purpose of this study is to review possible ways to improve the legal system.
○(Provision of universal medical services through public medical institutions)
–By ensuring access to basic medical services through public health care and providing an institutional basis to provide medical services that meet the needs of service users, who can be provided without unreasonable differences according to users’ socio-economic conditions in the area of essential health care? It aims to institutionally guarantee the provision of universally available medical services. As such, public health encompasses the entire medical service system that is organized, operated, and delivered in the public sector with the goal of providing universal medical services.
○ (Linking medical service delivery system with medical personnel and medical resources)
– Public health care is a concept distinct from the public nature of medical care, and it is based on a system in which the mark of publicity is realized through the entity of public entities and public institutions. Research on public health effectively secures human and material resources, such as medical personnel and medical facilities, and financial resources, as well as the delivery system of public sector health service organizations designed to practically guarantee the right to access medical care that guarantees universal availability of essential medical services. and covers the legal and institutional issues necessary for its operation.
– Legislative research for the improvement of public health covered in this report aims to analyze the system of public health from such a legal and institutional point of view and to seek legal alternatives.
Ⅱ. Main Content
○ (2nd Basic Public Health and Medical Care Plan)
– 2021. 4. The Ministry of Health and Welfare announced the 2nd public health and medical basic plan ('21~'25) and held a public hearing. The primary public health care master plan ('21~'25) was discussed.
– The 2018 Comprehensive Public Health Measures are to close the medical gap, respond to crises, and strengthen the public foundation of medical human resources. The main contents are cooperation in the process of improvement, medical equity, and public health policy implementation.
– The medical gap includes the right to access to medical care and the quality of medical services, and crisis response is related to an infectious disease crisis of a catastrophic nature and an appropriate response system of the emergency medical system in normal times.
– Medical human resources is related to establishing a structure in which medical personnel and medical personnel can strengthen their professionalism through training through medical services provided in the public sector and ensure appropriateness in the socio-economic compensation system.
○ (Direction of improvement plan for the public medical system)
– In order to find alternatives to devise ways to improve the public medical system, the right to access to medical care is strengthened by providing medical services centered on public medical institutions, which are the main contents of the legal foundation of public medical care, and the professionalism of medical personnel in public medical institutions is strengthened. By reinforcing the physical and human bases of public medical care with such medical facilities and medical personnel as the two pillars, we prepare a legislative alternative that can move toward strengthening the responsibility of public actors in the public health service delivery system, and It is necessary to review the legislative improvement plan so that the same legislative alternative can be harmoniously developed with the current medical law system.
▶ Summary of main issue
○ (Legal Value of Public Medical Law)
– Public health is an activity that guarantees the universal availability of medical care for the people, and 'universal health care' is a concept that includes practical values that allow anyone to receive appropriate medical services beyond the limits of time, space, and financial hardship. am. Public health care should start from fundamental legal ideologies such as freedom and human rights and basic legal principles such as distributive values and principles of equity. Alternatives should be evaluated and considered.
○ (Necessary to aim for publicity based on cooperation between the public and the private sector)
– On the one hand, the immediate task in the medical field of improving medical access in medically vulnerable areas and strengthening the medical safety net in medical blind spots should be solved from the perspective of improving 'public health care' centered on public medical institutions, and on the other hand, It is desirable to solve these problems through cooperation while nurturing medical personnel through private medical institutions, delivering medical benefits, and maximizing the capabilities of medical technology. As such cooperation between the public and private sectors is necessary for the improvement of public health care, it is necessary to make efforts to secure ‘publicity’ in the roles and responsibilities of private medical institutions, which form the backbone of the medical service delivery system. And at the same time, since medical insurance through public medical institutions is a key means of guaranteeing the people's right to health, the foundation for stably supporting the human resources and finances of public medical institutions should be expanded.
– When trying to solve the immediate task of public health from the cooperative point of view as above, it is not advisable to classify the types of medical institutions according to the providers of medical services and set the boundaries of each medical institution, and to classify the areas of responsibility for public health. It is necessary to reaffirm the legal value of 'publicity' inherent in medical services and make efforts to jointly seek ways to realize publicity in the medical service delivery system.
○ (Perspective of integrated medical service delivery system)
– This report examines the historical development of Korea's medical service delivery system, and at the same time examines the systems of the UK and France where medical services are provided centered on the public sector from a comparative law point of view, thereby providing an integrated medical service delivery system. From the perspective of public health, it is confirmed that it is important to ensure the implementation of public health services through cooperation between the public and private sectors in carrying out the functional responsibilities and duties of public health.
○ (Private medical and public medical services jointly fulfill the functional responsibility and mission of ‘public medical care’)
–In order to improve the operation of public medical institutions and increase the quality of services, cooperation with private medical institutions is required. Therefore, beyond the current legal system of the public medical law system that divides the medical service provision system centered on physical facilities, we set a higher goal of public health of medical care, and increase the patient's right to access medical services through cooperation between the private and public. It is desirable to improve in stages as a way to secure equity in the distribution of medical service availability.
○ (Securing public responsibility of public medical institutions in providing essential medical services)
– However, mutual cooperation presupposes that the unique roles of each part are established, and the provision of essential medical services through public medical institutions established and operated by the state or public entities due to the public good characteristics of medical services empirically There are areas where this must be done. If a public medical institution is not in charge of such essential medical service functions, there is a risk that such an essential medical service may not be supplied. bear the For this reason, it is necessary to provide support for the continuous development of public medical centers and public medical projects that have been recently established and operated in each region, and it is necessary to publicly guarantee the legal responsibilities of public medical institutions.