南朝鲜传统的卫生保健制度规定,卫生保健费用由使用者自付,政府对卫生保健市场也极少干预。由于南朝鲜在近三十年来发展迅速,卫生状况也有很大改进。预防、诊断、人口老龄化和疾病模式的变化,引起卫生保健成本的大幅度上升,使患者不堪负担。70年代中期,南朝鲜开始改进卫生保健制度,推出带有强制性质的“国家健康保险制度”(NHI),在全国各个阶层逐步推行,到80年代末全部完成。该制度减轻了患者的负担,增强了全民族的健康意识和健康责任,政府也加强了干预能力,使卫生保健资金的筹措、政府的作用、消费者获得的卫生服务、市场结构和卫生保健费用都发生了显著的变化。但是“国家健康保险制度”规定的自付率过高,忽视了贫困者的利益,并且也没有能够很好地解决成本不断上涨的问题,故而还有待改进。本文通过对健康保险及其影响的论述,对南朝鲜的健康保险制度作了一番准确的描述,并且指出了其潜在的问题。 South Korea’s traditional health care system stipulates that health care costs are borne by users and the government has minimal intervention in the health care market. As South Korea has developed rapidly in the past 30 years, the health conditions have also greatly improved. Changes in prevention, diagnosis, ageing population, and disease patterns have caused a significant increase in the cost of health care and have made patients unaffordable. In the mid-1970s, South Korea began to improve the health care system and introduced the mandatory National Health Insurance System (NHI), which was gradually implemented in all levels of the country and completed by the end of the 1980s. The system has reduced the burden on patients, strengthened the nation’s health awareness and health responsibilities, and the government has also strengthened its intervention capacity to raise funds for health care, the role of government, health services for consumers, market structure, and health care costs. Significant changes have taken place. However, the “national health insurance system” stipulates that the self-payment rate is too high, ignoring the interests of the poor, and it has not been able to solve the problem of rising costs. Therefore, it still needs improvement. Through the discussion of health insurance and its impact, this article gives an accurate description of South Korea’s health insurance system and points out its potential problems.