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영어

Korea is in the rapid aging process and has increasing number of households of elderly singles and couples due to increase in number of nuclear family. Since the social environment of women has changed, economically active female population has increased, and caregiver for the elderly population has decreased. Accordingly, thoughts that protection of traditional family and the caregiver has reached its limits arose, and in July 2008, “Long Term Care Insurance for The Elderly” was enacted to emphasize social responsibility for the elderly problems as a new system. Enactment of this Act was expected to improve the quality of life of the people by stabilizing the elderly life and reducing the burden of their families. However, the current long term care insurance for the elderly has not retrieved much success, after five years of its enactment. In this paper, the following improvements were suggested. First, the limited range of subjects aged 65 or over or under 65 with elderly specific disease such as dementia or cerebrovascular disease was considered to be expanded step-by-step, and whether to concentrate on serious cases or to provide service to large number of patients with mild symptoms must be considered as well. Second, expansion of the current long-term care benefits and payments that are limited to home salary, facility reimbursement, and special cash benefits method is suggested. Instead of having set reimbursement for each grade, having set payment considering degree of disability within each grade and a method such as the preventive benefit plans Furthermore, improvements of inequity between users of long term care facilities that are regulated by the Long Term Care Hospital care fee regulations and those who do not due to problems in inequity by paying fees equally or similarly. Also, care provider in family relationships were not being treated fair financially, so the need of improvement was called. Third, the need of mitigation of validate period for the operation and the use of long term care insurance for the elderly, which is too short for those who has the care grade of 1, strengthen the authority of National Health Insurance Corporation to resolve problems caused by absence of power to designate, cancel, question, and inspect, and the need of permissions to create the long term care institutions to prevent installation of institutions that cannot guarantee the quality, which has been a problem since many facilities were built carelessly to initiate the enactment, have been suggested. Additionally, providing more specific information about long term care institution since the care receivers do not have enough information for institution selection, and securing expertise on visiting investigators from grade decision committee to ensure reliability and objectivity of them since their lack of expertise have brought their reliability into question have been pointed out. And provision which requires either one of physician or doctor to rule the grade may needs to be stricter as needed. Also, certain legal basis are needed to be set for the care service in order to improve treatment of care workers, secure expertise of care workers, and regulate the quality of service of care facilities. On the other hand, reviewing introduction of independent evaluation task force might be necessary since the evaluation of long term care facilities is exclusively entrusted on National Health Insurance Corporation, calling problems due to excessive control. Increasing quality of care workers instead of quantity should be in priority, along with strict and specific standards on their curriculum. Forth, most of elders who does not have financial support will hesitate to use the long term care insurance if the burden is high. Thus, individual deductibles. Long Term Care Insurance for the Elderly has performed its role for four years in the Republic of Korea, and might not be right time to evaluate and judge the system yet. However, continual improvement and fixation to problems occurred thus far will certainly accelerate settlement of the long term care insurance for the elderly.