The Underlying Values of Social Insurance: the Frayed Edges of exclusion as a Clue

Abstract

Based on how social exclusion/inclusion is positioned from the perspective of social policy, we discussed the issue of exclusion in the universal health insurance system. The “certificate of eligibility” issue in national health insurance can be positioned as a problem of exclusion in the universal health insurance system, but the reason why such a phenomenon occurs can be attributed to the values held by the social insurance policy. Social insurance is designed on the premise of a free market with a low paternalistic element, which makes it easy to maintain a high level of universal benefits and to be accepted by the public. It is believed that such a value norm has been adopted in order to achieve the objectives of social stability and social integration as a social policy, while respecting private property rights, in order to make it feasible in reality. However, it is also important for the sustainability of the system to address the issue of “exclusion,” which is an omission from that value norm. The key to this is the extent to which the system of premium reduction and exemption should be expanded, but the issue of such exclusion has not been examined extensively.