스위스에서의 국민투표에 의한 보완의학 건강보험 급여화 사례 연구
A case study on benefit coverage of complementary medicine in public health insurance by the referendum in Switzerland
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Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the ‘Programm Evaluation Komplementärmedizin (PEK)’ and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and costeffectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.
Abstract
Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the ‘Programm Evaluation Komplementärmedizin (PEK)’ and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and costeffectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.
참고문헌 (34)
- U Brügger, "Health technology assessment in Switzerland: a descriptive analysis of “Coverage with Evidence Development”decisions from 1996 to 2013", BMJ Open, 5, pp.1~10 (2015)
- Plan about appropriate coverage of health insurance, "Korea Institute for Health and Social Affairs", ~ (2007)
- 이연주, "2007년 이후 한의약 분야의 신의료기술 현황", 대한한의학회지, 38(1), pp.21~33 (2017), 대한한의학회
- 3rd Comprehensive development plan of Korean medicine 2016-2020, "Ministry of Health & Welfare", ~ (2016)
- MY You, "Use of economic evaluation of new drugs and change of drug price system", J. Kor. Soc. Health-Syst. Pharm, 31(6), pp.1044~1053 (2014)
- Publication Committe on Year Book of Traditional Korean Medicine, "2015 Year Book of Traditional Korean Medicine" (2015), Korea Institute of Oriental Medicine, The Association of Korean Medicine, National Development Institute of Korean Medicine, Pusan National University School of Korean Medicine
- CM Witt, "The gap between results from sham-controlled trials and trials using other controls in acupuncture research-the influence of context", Complement Ther Med, 21(2), pp.112~114 (2013)
- N Nissen, "What attitudes and needs do citizens in Europe have in relation to complementary and alternative medicine?", Complementary Medicine Research, 19(Suppl. 2), pp.9~17 (2012)
- CAM use in Europe – The patients’ perspective. Part II: A pilot feasibility study of a questionnaire to determine EU wide CAM use, "S Eardley", ~ (2012)
- "International Health Care System Profiles"[URL]
- V Fønnebø, "CAMbrella Work Package2-Legal status and regulation of CAM in Europe", The 7th Framework Programme of European Union Commision, ~ (2012)
- Health Systems in Transition-Switzerland, "European Observatory", ~ (2015)
- Taking Health to heart, "Federal Office of Public Health", ~ (2015)
- 임문혁, "스위스의 의료보험 개혁동향과 과제", 보건경제와 정책연구, 18(4), pp.85~108 (2012), 한국보건경제정책학회
- "Bundesgesetz über die Krankenversicherung(KVG)"[URL]
- HP Studer, "A Busato. Development of Costs for Complementary Medicine after Provisional Inclusion into the Swiss Basic Health Insurance", Forsch Komplementmed, 18, pp.15~23 (2011)
- D Melchart, "Programm Evaluation Komplementärmedizin(PEK)", Bundesamt für Gesundheit, ~ (2005)
- L Rist, "Complementary medicine in the political process" (2009), S. Karger Publisher
- H Walach, "The Swiss program for the evaluation of complementary medicine(PEK)", The journal of alternative and complementary medicine, 12(3), pp.231~232 (2006)
- H Walach, "Summary consensus statement of the review board of the Swiss complementary medicine evaluation programme, (programm evaluation komplementarmedizin, PEK) regarding the PEK process and products", Homeopathy, 95, pp.28~30 (2006)
- "Swiss federal referendum of 17.5.2009"[URL]
- "Swiss Federal Office of Public Health"[URL]
- "CAM Regulation"[URL]
- "Swiss association of complementary medicine (Dachverband Komplementarmedizin)"[URL]
- The compulsory health insurance in a nutshell, "Federal Office of Public Health", ~ (2015)
- "Verordnung über die Krankenversicherung(KVV)"[URL]
- "Complementary medicine in switzerland now a mandatory health insurance service", Dachverband Komplemenrarymedizin. 2017. 7.16, ~ (2017)
- N Nissen, "CAMbrella Work Package 3-Citizens’ needs and attitudes towards CAM", The 7th Framework Programme of European Union Commision, ~ (2012)
- P Portwich, "The Swiss social insurance system:social security and grass-root democracy", International social security review, 64(1), pp.95~110 (2011)
- "Swiss federal referendum of 05.06.2016 Template No. 601 Overview"[URL]
- "Swiss federal referendum of 29.11.2009"[URL]
- FH Fischer, "High prevalence but limited evidence in complementary and alternative medicine : guidelines for future research", BMC Complementary and Alternative Medicine, 14, pp.46~54 (2014)
- 김동수, "대만 중의 건강보험의 체계와 서비스 질 향상 정책", 대한예방한의학회지, 20(2), pp.27~38 (2016), 대한예방한의학회
- N Nissen, "Public health ethics for complementary and alternative medicine", European Journal of Integrative Medicine, 5, pp.62~67 (2013)