미국 건강보험 전업사 등장의 역사적 배경과 발전 과정
The Historical Background on the Emergence of the U.S. Health Specialized Insurance Companies and Their Development
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노령화로 인한 의료비의 급격한 증가로 건강보험에 대한 관심이 고조되고 있다. 현재 국내 민영 건강보험은 모두 보험사의 일개 비즈니스 라인으로 인식되고 있어 역사적 배경에 관한 논의와 연구는 매우 미흡한 실정이다. 미국의 경우 건강보험 사업만을 전문으로 하는 민영 건강보험 전업사가 1990년대에 등장하여 현재까지 이어져오고 있다. 민영 건강보험 전업사의 등장에는 1965년 도입된 미국의 공적 건강보험인 메디케어(Medicare)와 메디케이드(Medicaid)가 1980년대 후반부터 의료비 보상율을 축소함으로 인하여, 의료서비스 제공자와 민영 건강보험사 간의 상호 의존도가 증가하면서 가입자가 급격히 증가하여 관리의료 형태로 민영 건강보험 산업이 발전할 수 있었던 것이 중요한 배경이 되었다. 1990년대부터 주요 건강보험 전업사들은 M&A를 통하여 치열한 가입자 유치 경쟁에서 생존하였고, 이를 통하여 미국 전역에 걸친 시장지배력을 공고히 하며 현재의 지배사업자로서의 지위를 획득하게 되었다. 2000년대 들어서 이들 건강보험 전업사들은 독점적 지배력을 중심으로 높은 이윤율을 달성함과 더불어 이윤율이 점차 수렴하여 현재와 같은 안정적인 주요 건강보험사로서 자리매김하게 되었다.
Abstract
The interest in health insurance has heightened due to radically increasing health care cost of aging population. Private health insurance is considered just as a business line by insurance companies, and there is few research on the historical background regarding specialties of health insurance business. In the U.S., private insurance companies specializing in health insurance emerged in the 1990s and have developed since then. The main historical background on the emergence of the U.S. health specialized insurance companies was supported by the developments of managed care health plan. The enrollment in the managed care dramatically increased because Medicare and Medicaid reduced reimbursement rates to pay hospitals in 1980s and therefore mutual dependences between health care service providers and private health insurance companies tightly reinforced. Major health specialized insurance companies survived through the battle of enrollment by M&As and consolidated their market power as market dominators throughout the 1990s. Since 2000, they have enjoyed high profits and return rates have converged among them as they have become major market monopolistic players.
참고문헌 (28)
- 김억헌, "A Historic Review on U.S. Life Insurance Company Tax Laws during 1980's-With Development of a Model Testing Tax Shifting Due to Tax Law Change-", 경영사학, (42), pp.105~136 (2006), 한국경영사학회
- 김영민, "인도에서의 마이크로 보험- TATA AIG와 VimoSEWA의 사례를 중심으로 -", 경영사학, 26(4), pp.123~155 (2011), 한국경영사학회
- 이홍무, "일본의 보험사업에 대한 규제의 역사적 고찰", 경영사학, 13(1), pp.191~214 (1998)
- 주요국의 민영건강보험의 운영체계와 시사점, "이창우", ~, pp.조사보고서 2010-3 (2010)
- 최병호, "미국 의료개혁의 정치경제학", 보건경제와 정책연구, 17(1), pp.71~101 (2011), 한국보건경제정책학회
- 정영호, "미국의 의료개혁과 시사점", 국제노동브리프, 6(5), pp.20~35 (2008)
- Boccuti, C., "Comparing Medicare and Private Insurers: Growth Rates in Spending over Three Decades", Health Affairs, 22(2), pp.230~237 (2003)
- Carlstrom, C. T., "The Government's Role in the Health Care Industry: Past, Present, and Future, FRB Cleveland" (1994), Economic Commentory
- Christianson, J. B., "The HMO Industry: Evolution in Population Demographics and Market Structure", Medical Care Review, 48(1), pp.3~46 (1991)
- Cunningham, III Robert, "The Blues: A History of the Blue Cross and Blue Shield System" (1997), Northern Illinois University Press
- Enthoven, A. C., "The History and Principle of Managed Competition", Health Affairs, 12, pp.24~48 (1993)
- Feldman, R. D., "HMO consolidations: How National Mergers Affect Local Markets", Health Affairs, 18(4), pp.96~104 (1999)
- Fuchs, V. R., "Economics, Values and Health Care Reform", AER, 86(1), pp.1~24 (1996)
- Goldman, D. P, "US Health Care: Facts about Cost, Access, and Quality, Rand Corporation", ~ (2005)
- Gorman, L., "The History of Health Care Costs and Health Insurance" (2006), Wisconsin Policy Research Institute Inc
- Guteman, S., "Hospital Cost Growth Down", Health Affairs, 15(3), pp.4~139 (1996)
- Health Research, "Employer Health Benefits 2008 Annual Survey", Kaiser Family Foundation (2009)
- Hoy, E. W., "Change and Growth in Managed Care", Health Affairs, 10(4), pp.18~36 (1991)
- Luft, H. S., "Medicare and Managed Care", Annual Review of Public Health, 19, pp.459~475 (1998)
- Marquis, M. S., "Trends in Managed Care and Managed Competition, 1993-1997", Health Affairs, 18(6), pp.75~88 (1999)
- Matheson, D., "New Levers and New Strategic Choices", The Emerging World of Medical Management 1 (2007), The Boston Consulting Group
- Mayes, R., "Causal Chains and Cost Shifting: How Medicare's Rescue Inadvertently Triggered the Managed Care Revolution", The Journal of Policy History, 16(2), pp.144~174 (2004)
- Miller, R. H., "Managed Care Plans: Characteristics, Growth, and Premium Performance", Annual Review of Public Health, 15, pp.437~459 (1994)
- Oberland, J. B., "Managed Care and Medicare Reform", Journal of Health Politics, Policy, and Law Spring 1996 Conference (1996)
- Robinson, J., "Consolidation And The Transformation Of Competition In Health Insurance", Health Affairs, 23(6), pp.11~24 (2004)
- Robinson, J., "Reinvention of Health Insurance in the Consumer Era", The Journal of the American Medical Association, 29(15), pp.43~55 (2004)
- Shen, Yu-Chen, "Is Managed Care Still an Effective Cost Containment Device?, Frontiers in Health Policy Research Vol 9" (2006), NBER Books, NBER Inc
- Strunk, B. C., "Tracking Health Care Cost: Declining Growth Trend Pauses in 2004" (2005), Health Affairs, Web Exclusive