요양기관당연지정제의 법정책적 타당성에 대한 소고 - 헌재 99헌바76 결정례에 대한 비판적 검토를 중심으로 -

Under the current national health insurance system, every medical institution is required to be appointed as a medical service provider which should provide medical services to an insured of the national health insurance. In case where an medical institution is involved to national health insurance system by such appointment, the medical institution is obliged to follow the medical service guideline which has been arbitrarily provided by the Ministry of Health and Welfare. Under such circumstances, it is impossible for the medical institution which are subject to the national health insurance system to conduct creative and individualized health care for its patients. If the National Health Insurance Act admits limited number of medical service providers to provide privatized services to their patients out of control of the national health insurance system, it is expected that (i) the national health insurance system could save its budget and concentrate its saved resources on more crucial demands since some portion of relatively rich patient would choose to receive privatized medical services without reimbursement of the national health insurance system, (ii) such patients would be satisfied with more individualized high-quality medical services and (iii) the entire medical industry's competitiveness would be enhanced. Considering these expected advantages, it is needed for us to reconsider “automatic appointment regime of medical service providers without exception” under national health insurance system.