독일건강보험법의 기본모형과 개혁논의

German Health Insurance Act has taken actions to reform a structure in the field of health insurance since 1989. These actions are classified as four steps. Health Insurance Reform Act of 1989 would readjust social solidarity and rules of self-responsibility in health insurance and improve insurance services economy. Health Insurance Changing Organization Act of 1993 concentrated on cost controls to health care providers including medical personnel. The bare skeleton of the third Health Insurance Reform Act of 1997 was that in case of increasing the rate of insurance, self-insured cost of an insured was raised by legal provisions and many private insurance factors were introduced into the public health insurance. The purpose of Modernizing Health Insurance Institution Act of 2003 were the improvement of the quality of medical services, balanced finance in health insurance, the pursuit of stability of an insurance bill, etc. These series of actions in the structural reform of German Health Insurance Act provide a goal of our healthl insurance system with several suggestions. In the first place, in the point of institutional evaluation of health insurance system our medical insurance system should be reexamined about how much it was appropriate to an institutional purpose. Second, as a structural problem of health insurance the General Group Contract(GGC) in force cannot fulfilled its functions practically. It is required, therefore, that this General Group Contract should be transferred the Individual Group Contract(IGC) by diversifying an insured's opponents. Finally external and comprehensive environmental factors surrounding health insurance must be predicted and the solution to such factors must be presented.