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홍차넷
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뉴스
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- 새로운 뉴스를 올려주세요.
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전체기타정치IT/컴퓨터방송/연예스포츠경제문화/예술사회게임의료/건강과학/기술국제외신
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| Date |
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| Name | 뉴스테드 |
| Subject | 건강보험 개혁하겠다는 윤석열 정부, 무엇을 놓치고 있나 |
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https://n.news.naver.com/article/308/0000032079?cds=news_media_pc “건강보험 문제의 해결 방안은 건보 내부가 아니라 건보 밖에 있다.” 건보만 들여다본다면 건보 개혁의 원리는 간명하다. 현 정권의 기조처럼 보장성 확대를 중단하고 재정 누수를 막아 ‘지출’은 줄인다. 보험료를 올리고 법으로 정해져 있지만 정부가 매년 지키지 않았던 국고보조금 20%를 건보공단에 제대로 지원해 ‘수입’은 늘린다. 물론 이런 정책들을 현실화하는 건 어려운 일이지만 ‘해법’ 자체는 비교적 단순하다. 그러나 건보 개혁이 덧셈 뺄셈의 접근법에 그친다면 정말 목표로 했던 건보의 지속가능성은 지켜낼 수 없다. 우리 앞에 놓여 있는 문제의 스케일이 너무 크기 때문이다. 한국 보건의료체계에 내재한 ‘무한증식 루프’를 그대로 둔 채 초고령화 사회에 본격 진입한다면 건보 수준에서 지출 조정을 한다 해도 보험료를 엄청나게 올리지 않고는 이를 따라잡을 수 없다. 실효성 있는 ‘진짜’ 건보 개혁이 되려면 건강보험뿐만 아니라 한국 보건의료체계의 나머지 두 주체인 이용자와 공급자도 움직여야 한다. 그러니 건보 개혁은 곧 한국 보건의료 개혁과 동의어인 셈이다. “건보 문제 해결 방안은 건보 밖에 있다”라고 했던 보건의료학자는 “건강한 국민”과 “합리적인 공급자”가 개혁의 키워드라고 말했다. 인구 전체의 고령화는 막을 수 없더라도 ‘건강수명’을 늘려서 노인성 질환으로 의료비가 증가하는 시기를 미루고, 앞서 살펴봤듯이 지나치다 싶을 만큼 빈번하게 병의원을 찾는 의료 이용 패턴을 전환하는 과제가 이용자들 앞에 놓여 있다. 공급자들은 과잉 진료 관행에서 벗어나 환자의 건강을 지키는 데 꼭 필요한 ‘적정 의료’를 제공하는 방향으로 나아가야 한다. 전체적으로 보면 확장 지향적이었던 한국 보건의료 시스템을 멈춰 세우고 대신 질적·구조적 상향을 꾀하는 작업이 이루어져야 한다. 불필요한 의료 수요를 조절하기 위해 국민들은 지금까지 누리던 의료 접근성과 선택권에 일부 제한을 두는 정책을 받아들여야 할 수도 있다. 공급자 측면의 과잉을 방지하기 위해서는 ‘행위별 수가제’에서 의료비 총액을 제한하는 ‘묶음 방식’의 지불제도로 변경하는 방안이 제시된다. 공공병원을 확대하려는 노력은 ‘적정 의료’를 제공하는 합리적 의료 공급자 모델을 정착시키려는 목적도 가지고 있다. 보건의료 개혁과 관련해 다양한 정책과 제안이 쏟아지고 무수히 많은 논의가 오갈 수 있다. 한 가지 분명한 사실은 그 가운데 무엇을 택하든 이용자인 국민과 공급자인 의료계가 ‘새로운 규범’을 받아들이도록 설득해내야 나아갈 수 있는 길이라는 것이다. 민간 상품인 실손보험이 얽혀 있고, 노령인구에 접어든 윗세대와 더 많은 건강보험료를 부담해야 할 아랫세대 간의 조율이라는 성격까지 고려한다면 이는 실로 다양한 이해관계를 조정해야 하는 과업이다. 이 과정에서 각 주체는 지금까지 누리던 것 중 일부를 양보하고 내려놓아야 할 가능성이 높다. 그러니 건보 개혁이란 ‘한국 사회의 미래’라는 공동체적 가치를 내걸고 긴 시간 설득과 조정, 양보와 타협을 거쳐야 하는 고도의 정치 행위이기도 하다. 한 보건의료계 전문가는 “정권 지지율 90%가 필요한 정책”이라는 말로 건강보험 개혁의 어려움을 에둘러 표현했다. 대결적이고 적대적인 구도로는 넘을 수 없는 과제인 것이다. 2022년 12월13일 국무회의에서 건보 개혁의 필요성을 역설하는 대통령의 발언은 이전 정부를 비난하는 언어들로 채워졌다. 미래를 위해 지금 쥐고 있는 것을 조금씩 내려놓고 힘을 모으자는 호소는 들어설 자리를 찾지 못했다. 윤석열 정부는 ‘건강보험 개혁’이라는 분명한 시대적 의제를 꺼냈다. 그러나 윤석열 대통령의 리더십은 아직 시대를 따라가지 못하는 것처럼 보인다. ------------- 진영의 유불리가 아닌 우리나라 전체를 위한 개혁을 수행할 타이밍이 이번에도 아니구나 싶습니다. 이해의 조정자가 대통령이기를 바라는건 무리한 희망이겠지요. Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 133 Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 146 Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view.php on line 161 0 이 게시판에 등록된 뉴스테드님의 최근 게시물
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Warning: Use of undefined constant HTTP_HOST - assumed 'HTTP_HOST' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/cmt_replace.php on line 3
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 6
Warning: Use of undefined constant file_name - assumed 'file_name' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 28
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 65
257089 class="iamcmt" style="display:none;"> Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 66
257089 class='vcm '>
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 70
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 71
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 76
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 117
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 118
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 119
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 120
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 121
257089'> 고기먹고싶다
Warning: Use of undefined constant mod_date - assumed 'mod_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 133
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 140
Warning: Use of undefined constant reg_date - assumed 'reg_date' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 142
23/01/11 00:40
257089>삭제 주소복사
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 150
많은 지지자분들이 바라셨던대로 아무것도 안했으면 좋겠습니다. 노동개혁이던 연금개혁이던 정치개혁이던 다 필요해보이는데 얘네가 건드리면 지금보다 더 망가질거 같아서 ㅠ
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant level - assumed 'level' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 158
Warning: Use of undefined constant password - assumed 'password' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 166
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 171
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 172
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
Warning: Use of undefined constant vote - assumed 'vote' (this will throw an Error in a future version of PHP) in /home/redtea/html/a_skin/bbsd/view_comment.php on line 173
257089>
257089>
