Change in Insurance Contribution Burden by Scenario

Ⅴ. Effect of Reform in National Health Insurance Contribution Scheme:

2. Change in Insurance Contribution Burden by Scenario

A. Insurance Contribution Burden in Standard A

The income that is subject to insurance contribution in Standard A was calculated by adding up earned income, business income, financial income, annuity income and other incomes included in the individual-level data. In the case of households, the income was calculated by reorganizing the aforementioned individual-level income data by household and adding up the values. Insurance contribution was calculated by multiplying the household-level income mentioned above by half of each year’s contribution rate of the national health insurance.

<Table V-6> presents health insurance contribution and the contribution burden rate in Standard A, which were calculated using a series of data mentioned above. Health insurance contribution by household in Standard A shows a slight increase across all years under consideration from the current level. A slight increase is observed in the amount of contribution among households with the employee insured and among those with both the employee insured and the self-employed insured; the amount of contribution declines among households with the self-employed insured.

However, the ratio of contribution to household income—i.e. the contribution burden rate—is lowered in Standard A. This can be because the scope of income covered in Standard A is larger than the current scope. The rate of contribution burden is similar or increases among households with the employee insured, but the rate decreases significantly among households with the self-employed insured when Standard A applies. On the contrary, the contribution burden rate rises greatly among households with both the employee insured and the self-employed insured.

〈Table V-6〉Health Insurance Contribution and Contribution Burden Ratio by Household in Standard A

(Unit: 10,000 KRW, Ratio)

2009-2014 2009 2010 2011 2012 2013 2014

Health Insurance Contribution by Household (Current)

Contribution by Household (Standard A) Households with Both

the employee insured and the self-employed insured (Current)

Households with Both the employee insured and the self-employed insured (Standard A)

50.47

Contribution to Household

Income Ratio (Current) 0.0263 0.029 (.001) Contribution to Household

Income Ratio (Standard A) 0.0279 0.025 0.026 0.028 0.029 0.029 0.029 Households with the

0.025 0.026 0.028 0.029 0.029 0.029

Effect of Reform in National Health Insurance Contribution Scheme:

Longitudinal Analysis

71

〈Table V-6〉Continue

2009-2014 2009 2010 2011 2012 2013 2014

Households with the

0.025 0.026 0.028 0.029 0.029 0.029

Households with Both the Employee Insured and the Self-Employed Insured (Current)

Households with Both the Employee Insured and the Self-Employed Insured (Standard A)

0.025 0.026 0.028 0.029 0.029 0.029

Source: Calculated by the authors using the 2^nd to 7^th NaSTaB data

<Table V-7> presents the sum of incomes that are subject to contribution assessment, the sum of contributions, and the ratio of contribution burden to household income calculated based on longitudinal data in Standard A. Each year’s household incomes that are subject to contribution assessment and household contributions were converted to the price level of 2014 using the consumer price index. When the contribution scheme is changed to Standard A, the average of the sum of all incomes that are subject to contribution assessment for the 6 years between 2009 and 2014 stands at about 140 million KRW and average contribution is 5.85 million KRW. A slight increase is observed in the amount of insurance contribution in Standard A, compared to the current level.

The contribution burden ratio refers to the average ratio of the sum of each year’s household contributions to the sum of the same year’s household incomes.

Average household income and average household contribution refer to average values calculated by regarding the data between 2009 and 2014 as one pool of cross-sectional data. The contribution burden rate in Standard A calculated as above is 0.0279, which is a slight increase compared to the current level

(0.0263). The bottom of <Table V-7> shows the sum of household incomes that are subject to contribution assessment, the sum of household contributions, etc. with only the households investigated four times or more in the NaSTaB as subjects; the results indicate that there is not so much change in the contribution burden rate.

〈Table V-7〉Longitudinal Analysis of Standard A: Incomes Subject to Contribution Assessment, Household Insurance Contribution and Contribution Burden Ratio

(Unit: 10,000 KRW, Ratio) Average sum

of incomes subject to contribution assessment

Average sum of household contributions

Contribution burden ratio

Average of perhousehold

incomes subject to contribution assessment

Average household contribution

All households

2009-2014 14,605.35 585.07 0.0279 2,883.87 113.32

Households investigated 4 times or

73

〈Table V-8〉Average Income, Average Insurance Contribution and Contribution Burden to Income Ratio by Income Quintile in Standard A

(Unit: 10,000 KRW, Ratio)

Income Quintile 2009 2010 2011 2012 2013 2014

Quintile 1

Average Contribution

(Current) 18.76 22.41 23.14 23.72 23.57 25.26

Average Contribution

(Standard A) 15.15 17.16 17.36 19.93 19.20 19.99

Contribution Burden

(Standard A) 0.025 0.026 0.028 0.029 0.029 0.029

Quintile 2

Average Contribution

(Current) 43.98 40.85 47.69 50.06 55.48 56.26

Average Contribution

(Standard A) 41.79 44.75 50.63 54.26 55.92 57.64

Contribution Burden

(Standard A) 0.025 0.026 0.028 0.029 0.029 0.029

Quintile 3

Average Contribution

(Current) 74.80 76.58 82.29 85.22 96.01 99.80

Average Contribution

(Standard A) 71.15 77.03 87.94 93.28 96.52 101.09

Contribution Burden

(Standard A) 0.025 0.026 0.028 0.029 0.029 0.029

Quintile 4

Average Contribution

(Current) 107.34 105.58 122.48 132.34 149.57 157.72

Average Contribution

(Standard A) 107.51 115.47 133.04 142.02 150.39 156.84 Contribution Burden

(Standard A) 0.025 0.026 0.028 0.029 0.029 0.029

Quintile 5

Average Contribution

(Current) 178.36 184.73 212.90 226.66 255.51 267.59

Average Contribution

(Standard A) 201.63 213.52 250.13 265.32 288.64 292.36 Contribution Burden

(Standard A) 0.025 0.023 0.028 0.029 0.029 0.029

Source: Calculated by the authors using the 2^nd to 7^th NaSTaB data

B. Insurance Contribution Burden in Standard B

The income that is subject to insurance contribution in Standard B is calculated by adding up earned income, business income, financial income, annuity income and other incomes at the individual level and reorganizing the individual-level gross income into a house-level income. However, when the annual household income subject to contribution assessment was 3.36 million KRW or less, the minimum contribution was applied; if it exceeded 3.36 million KRW, the fixed-rate contribution was applied.

<Table V-9> presents health insurance contribution by household and the contribution burden rate calculated per household according to Standard B. In Standard B, household health insurance contribution increases in each year under consideration, compared to the current level. However, the ratio of household contribution to household income—i.e. the contribution burden rate—does not show much change although there exists a slight variation across the years.

Effect of Reform in National Health Insurance Contribution Scheme:

Longitudinal Analysis

75

〈Table V-9〉Health Insurance Contribution and Contribution Burden Ratio by Household in Standard B

(Unit: 10,000 KRW, Ratio)

2009-2014 2009 2010 2011 2012 2013 2014

Health Insurance Contribution by Household (Current) Health Insurance Contribution by

Household (Standard B)

85.37 Households with the Employee

Insured (Current) Households with the Employee

Insured (Standard B)

109.61

Self-Employed Insured (Current)

94.42

Employed Insured (Standard B)

73.80 self-employed insured (Current)

27.82 employed insured (Standard B)

52.09 Contribution to Household Income

Ratio (Current) Contribution to Household Income

Ratio (Standard B) 0.028 0.030 0.032 0.033 0.033 0.033

Households with the Employee Insured (Current) Households with the Employee

Insured (Standard B) 0.025 0.026 0.029 0.029 0.033 0.030

Households with the

Self-Employed Insured (Current)

0.057

Employed Insured (Standard B) 0.028 0.029 0.033 0.031 0.029 0.034 Households with Both the

Employee Insured and the Self-Employed Insured (Current)

0.006 Employed Insured (Standard B)

0.033 0.030 0.040 0.040 0.034 0.038

Note: ( ) means ratio.

Source: Calculated by the authors using the 2^nd to 7^th NaSTaB data

When Standard B is applied, average contribution increases and the contribution burden rate is similar or increases, compared to the current level, among households with the employee insured. As for households with the self-employed insured, both of the figures decrease.

<Table V-10> presents the sum of incomes that are subject to contribution assessment, the sum of contributions, and the ratio of contribution burden to household income calculated based on longitudinal data in Standard B. Each year’s household incomes that are subject to contribution assessment and household contributions were converted to the price level of 2014 using the consumer price index. When the contribution scheme is changed to Standard B, the average of the sum of all incomes that are subject to contribution assessment for the 6 years between 2009 and 2014 stands at about 140 million KRW and average contribution is 5.93 million KRW. A slight increase is observed in the amount of insurance contribution in Standard A, compared to the current level. A slight increase is observed in the amount of insurance contribution, compared to the current level.

The contribution burden ratio refers to the average ratio of the sum of each year’s household contributions to the sum of the same year’s household incomes.

Average household income and average household contribution refer to average values calculated by regarding the data between 2009 and 2014 as one pool of cross-sectional data. The contribution burden rate in Standard B calculated as above is 0.0313, which shows an increase from the current level (0.0263).

The bottom of <Table V-10> shows the sum of household incomes that are subject to contribution assessment, the sum of household contributions, etc. with only the households investigated four times or more in the NaSTaB as subjects;

the results indicate that there is no significant change in both the contribution burden rate and average household contribution.

Effect of Reform in National Health Insurance Contribution Scheme:

Longitudinal Analysis

77

〈Table V-10〉Longitudinal Analysis of Standard B: Incomes Subject to Contribution Assessment, Household Insurance Contribution and Contribution Burden Ratio

2009-2014 14,633.13 593.03 0.0313 2,891.87 114.78

Households investigated 4 times or

79

in Standard A remains secured and that the respective shares of income-based and property-based contributions in the revenue are set at 80%

and 20%.

First, to deduce the rate of income-based contribution, the income subject to contribution was calculated by adding up earned income, business income, and financial income exceeding 20 million KRW, 50% of the public annuity income, and other incomes exceeding 3 million KRW per household. Then, we came up with the amount of income-based contribution by calculating incomes subject to contribution assessment per household and 80% of the total contribution revenue deduced according to Standard A.

The scope of property was limited to the data available in the NaSTaB, such as housing, buildings, land, ship and airplane, and the total amount of property was calculated using this data. The scope of property that is subject to the insurance contribution assessment can be adjusted when the scope of assets, such as key-money lease/the monthly rent and debts, is determined in the future. In that respect, we used the sum of the property data available in the NaSTaB for the present in Standard C of this study. Based on this, property-based contribution, which is to cover 20% of the contribution revenue in Standard A, was deduced. As shown in the <Table V-12>, the rate of income-based insurance contribution to cover the contribution revenue in Standard A is about 2%; the rate of property-based insurance contribution stands at about 0.15%.

<Table V-12> presents changes in the rate of household insurance contribution burden when Standard C is applied. The contribution health insurance burden rate by household in Standard C is similar to those in Standards A and B. The contribution burden rate decreases for households with the employee insured and households with the self-employed insured whereas the burden rate increases for the households with both the employee insured and the self-employed insured. When compared with Standard A, which collects the same amount of insurance contribution revenue, the insurance contribution burden rate decreases relatively for households with the employee insured; the figure increases slightly for households with the self-employed insured and households with both the employee insured and the self-employed insured.

〈Table V-12〉Income-Based Contribution Rate and Property-Based Contribution Rate By Household in Standard C

(Unit: Ratio)

2009-2014 2009 2010 2011 2012 2013 2014

Income-based insurance contribution

rate (Standard C) 0.02031 0.02174 0.02314 0.02349 0.02422 0.02451 Property-based insurance contribution

rate (Standard C) 0.00148 0.00158 0.00167 0.00121 0.00125 0.00128 Insurance contribution compared to

household income (Current)

0.029 Households with the Employee

Insured (Current) Households with the Employee

Insured (Standard C) 0.020 0.020 0.019 0.022 0.022 0.023

Households with the Self-Employed Insured (Current) Households with the Self-Employed

Insured (C) 0.024 0.029 0.031 0.029 0.031 0.031

Households with both the employee insured and the self-employed insured (Current) insured (Standard C)

0.035 0.023 0.028 0.026 0.028 0.030

Source: Calculated by the authors using the 2^nd to 7^th NaSTaB data

<Table V-13> shows the result of weighted calculations where average household insurance contribution and the contribution burden rate are classified into 5 income quintiles according to Standard C. Average contribution increases as the income quintile increases, but the contribution burden rate decreases as the income quintile increases. When compared to Standard A in <Table V-6>, the contribution burden rate of the low-income class increases while that of the high-income class decreases in relative terms. When Standard A is applied, the difference in the contribution burden rate is not great between Income Quintile 1 and Income Quintile 5. When Standard C is applied, however, the contribution burden rate of Quintile 1 increases greatly while that of Quintile 5 decreases significantly. Therefore, it can be expected that the income redistributive effect of Standard C is negative, compared to Standard A even

Effect of Reform in National Health Insurance Contribution Scheme:

Longitudinal Analysis

81

when the same amount of contribution revenue is assumed to be secured in both scenarios.

〈Table V-13〉Income, Insurance Contribution and Contribution Burden to Income Ratio by Income Quintile in Standard C

(Unit: 10,000 KRW, Ratio)

Income Quintile 2009 2010 2011 2012 2013 2014

Quintile 1

Average Contribution 16.68 17.82 19.47 21.31 21.95 24.19 Contribution Burden 0.044 0.032 0.041 0.035 0.039 0.041 Quintile

Average Contribution 37.58 38.67 42.74 48.31 50.79 51.27 Contribution Burden 0.023 0.023 0.023 0.025 0.026 0.027 Quintile

문서에서 The Effects of Reform in the National Health Insurance Contribution Scheme: on Equity in Health Insurance Contribution Burden (페이지 71-83)