'의료민영화' 정책과 이에 대한 사회적 대응의 역사적 맥락과 전개

초록

Health care system in Korea is showing a divisive aspect and at the heart of the development is the health care privatization policy. Confusions revolving around the policy have evolved primarily from the conflict between ‘Publicness’ that has represented an ‘official’ideology of the health care system in Korea and the other principle upheld by ‘Market or Profit’ that has recently gained legality in the field of health care services. The conflict between ‘Publicness’ and ‘Market or Profit’ that represents the bottom line of confusion within health care system has historical context. The health care system in the southern half of the Korean Peninsula took on a highly ‘abnormal’ format that blended the remnants of the Japanese rule, exclusion of radical ideals, transplantation of American institutions and compulsion ‘from outside’, creating the origin of the ‘divisive’ landscape of today. During the era of dictatorial rule, cases for economic development or political legitimation prevailed over health care policies,minimizing support for the public health care system. And the ‘tacit collusion’ between the government and the health care providers strengthened the irrationality of health care system in Korea. Against the backdrop, Korean society that fell victim to the financial crisis in 1997 succumbed to the influence of neo-liberalism and health care privatization was born on the base of the 1997 regime. As pro-market forces have dominated the executive and the legislative bodies in the Lee Myung-Bak administration, momentum is building up to pave the way for health care privatization to proceed in earnest. However, civil rights activists and trade unions that have advocated the publicness of healthcare service traditionally are protesting against such move. The health care privatization policy that the government is pushing for now 1) leans toward the interests of capital that private health insurers represent rather than promotion of health for the general public, failing to accommodate the interests of small healthcare service providers, socioeconomically-underprivileged regions or groups. 2) Stakeholders are not engaged in the policy making and implementation processes. 3) Anticipated dysfunctions of health care privatization are not indicated. 4) Scientific cases for the data presented by the government are unclear. Therefore, it is necessary to ensure democratic and public values subsequently by evaluating pros and cons of the policy scientifically, developing proper countermeasures and creating a process by which policy issues are discussed and public consensus is built.

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