Analysis of Pricing for the Sample Model of Myanmar’s National Health Insurance = 미얀마 국민건강보험 샘플모델에 대한 보험료 분석

국문 초록 (Abstract)

국민건강보험은 모든 국민의 의료비를 보호하기 위해 마련되었습니다. 한국, 인도네시아, 베트남과 같은 많은 아시아 국가들은 이미 어떤 형태로든 국민 건강 보험 제도를 가지고 있습니다. 국민건강보험제도가 있으면 개인의 의료비 부담을 덜 수 있다. 현재 미얀마에는 국민건강보험제도가 없습니다. 미얀마에서 이러한 시스템을 구현하기 위해 본 논문은 한국 건강보험공단을 벤치마킹한 샘플 모델을 제시한다. 모델 로드맵은 3단계로 구성되며, 본 논문에서는 1단계에 중점을 둔다. 미얀마의 NHI는 초기에 정부 병원의 입원환자 입원을 보장해야 하며 직원이 300명 이상인 민간 기업과 모든 정부 직원에게 의무적으로 적용되어야 합니다. 모델에서 관찰된 기여 금액은 미얀마 시민들에게 공정해야 합니다.

다국어 초록 (Multilingual Abstract)

National health insurance is designed to protect the healthcare costs of all citizens. Many Asian countries, such as Korea, Indonesia, and Vietnam, already have some form of a National Health Insurance System. Having a national health insurance system can alleviate the burden of medical costs for individuals. Currently, Myanmar have no national health insurance system yet. In order to implement such a system in Myanmar, this paper presents a sample model based on the Korean NHIS as a benchmark. The model roadmap consists of three stages, and this thesis focuses primarily on the first stage. Myanmar's NHI should initially cover inpatient hospitalization in government hospitals and should be mandatory for private companies with 300 or more employees, as well as all government staff. The contribution amount observed in the model must be fair for the citizens of Myanmar.

목차 (Table of Contents)

• CHAPTER 1 – INTRODUCTION 1
• 1.1 History of Myanmar Insurance Industry 1
• 1.2 Health and social insurance of Myanmar 2
• 1.3 National Health Insurance System of Korea 3
• 1.4 Sample model for Myanmar’s NHIS 4
• CHAPTER 2 – LITERATURE REVIEW 6
• 2.1 Factors for individual health insurance pricing 6
• 2.2 Factors for national health insurance pricing 6
• 2.2.1 Utilization 7
• 2.2.2 Cost 7
• 2.3 The experience data 7
• 2.3.1 Internal data 7
• 2.3.2 External data 8
• CHAPTER 3 – DATA COMPARISON BETWEEN MYANMAR & KOREA 9
• 3.1 Population between Myanmar and Korea 9
• 3.2 GDP between Myanmar and Korea 10
• 3.3 Health Expenditure between Myanmar and Korea 12
• 3.4 Population pyramid between Myanmar and Korea 14
• 3.5 Average LOS in inpatient between Myanmar and Korea 15
• 3.6 Conclusion for chapter - 3 17
• CHAPTER 4 – MAKING A SAMPLE MODEL FOR MYANMAR’S NHI 18
• 4.1 Health Insurance Products of MI & SSO 18
• 4.2 Roadmap of Myanmar’s NHI sample model 19
• 4.3 Contribution analysis for inpatient cases 20
• 4.4 Contribution between Korea and Our Model 22
• 4.5 Outpatient and prescription situation in Myanmar 23
• 4.6 Contribution collection 24
• 4.7 Exclusions 25
• CHAPTER 5 - CONCLUSION 27
• REFERENCES 29