원문정보
초록
영어
Traditionally, the Supreme Court has held that medical treatment agreements covered by national health insurance should be distinguished from other medical treatment agreements which are viewed as a consummation of the autonomous free will between doctor and patient. Namely, the Supreme Court views medical treatment agreements covered by national health insurance to be bound by the National Health Insurance Law with the intent to promote the applicability and comprehensiveness of the national health insurance scheme. Yet, issues of voluntary non-reimbursable treatments are triggered not only by the mistakes or moral hazard of medical care institutions but also by systemic limitations of national health insurance coverage criteria. Thus, there is a need for legislative measures that allow certain medical treatments to be included or reflected in the national health insurance coverage system so that patients may receive prompt and flexible medical treatments. To reflect such concerns, the Supreme Court made an exception for voluntary non-reimbursable treatments and developed a strict test to be applied in such cases in Supreme Court Judgment 2010 Doo 27639, 27646 (ruled on June 8, 2012 by the Grand Bench). Such judgment, however, is not a fundamental overturn of the Supreme Court’s prior rulings that voluntary non-reimbursable treatments are not allowed under the law. It is only a slight revision of its previous stance for cases in which there is a lack of legislative measures to make coverage of a new yet valid medical treatment possible under the current national health insurance coverage system.
목차
1. 사건의 개요
2. 제1심 및 원심판결의 요지
3. 대상판결의 요지
4. 이 사건의 쟁점
II. 국민건강보험의 체계와 부당이득 환수처분의 법리
1. 국민건강보험제도의 헌법적 기초
2. 국민건강보험의 체계와 특성
3. 국민건강보험법상 부당이득 환수처분의 법리
III. 임의비급여의 허용여부와 허용조건에 대한 검토
1. 요양급여에 관한 법령 체계
2. 임의비급여의 개념
3. 임의비급여의 유형
4. 임의비급여의 허용여부에 관한 검토
5. 제한적 허용조건에 대한 검토
IV. 행정소송에서의 증명책임
1. 이 사건에서 논의의 구조
2. 행정소송에서의 증명책임에 관한 일반적인 논의
3. 이 사건에서의 검토
V. 이 판결의 의의
참고문헌
ABSTRACT