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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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| Name | 카르스 |
| Subject | “전공의 돌아오라” 했던 국립중앙의료원 주영수 원장의 작심 발언 |
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발언 하나하나가 민감한 상황이다. 꼭 전달하고 싶은 얘기가 있었나? 이번 사건이 단순히 의대 정원을 확대하는 이슈로 이해되어서는 안 된다는 것이 내 생각이다. 한국 보건의료 정책의 변화 흐름 속에서 생긴 사건으로 바라봐야 한다. 그래야 문제의 본질이 드러난다. 어찌 보면 정부의 성격과 맞지 않는 일이 벌어진 셈이다. 시장 주도 시스템으로 국정을 운영하려는 정부이고, 의료 영역만 하더라도 민간 의료기관을 중심에 둔다. 그런데 아이러니하게도 정부의 정책 기조와 매우 동떨어진 방향의 보건의료 기조가 만들어지고 있는 것이다. 정부의 고유한 철학과 확고한 의지에서 출발했다고 보지는 않는다. 기존 보건의료 체계가 한계에 부딪혔고 그 결과 응급실을 찾아 헤매거나 대형 병원 간호사조차 원내에서 뇌출혈로 사망하는 사건처럼 필수의료 분야에서 발생하는 문제가 점점 더 심각해지고 있다. 의대 증원과 필수의료 정책은 그런 전반적인 흐름 속에서 제시된 것이다. 2월6일 의대 정원 2000명 확대 발표에 앞서, 지난해 하반기부터 보건복지부는 몇 차례에 걸쳐 정책 시리즈를 내놓았다. 10월19일 ‘지역 완결적 필수의료 혁신 전략’이란 이름으로 핵심 의제를 제시했고, 올해 2월1일 ‘필수의료 정책 패키지’에서는 세부 실행 과제를 포괄적으로 담았다. 2월2일에는 제2차 국민건강보험 종합계획을 발표했다. 그동안 보건의료계에서 논의해온 것을 진일보한 수준으로 망라했다. 적어도 내가 보기에는 한국 보건의료의 발전 단계에 부합하는 내용이다. 개혁적 보건의료단체들과 달리, 제가 이번 정책들에 덜 비판적인 이유이다. 전체 패키지를 꼼꼼하게 살펴보면 방향이 틀렸다고 말하기는 어렵다. 의대 증원은 이 일련의 정책 구상에서 핵심 전략 가운데 하나다. 시장중심적이고 친(親)의사적인 보수 정권에서 2000명이라는 수치를 과감하게 제시했다. 이것은 전향적 시도라고 평가하고 싶다. (계속) 정부가 내놓은 일련의 필수의료 정책들이 어떤 점에서 한국 보건의료의 단계에 부합하나? 보건의료의 여러 영역을 아우르는 내용이 다층적으로 연결돼 있어서 일일이 설명하기는 어렵지만, 분명 기존 논의에서 한 걸음 더 나아갔다고 봐야 하는 정책들이다. 예를 들어 2월1일 발표된 ‘필수의료 정책 패키지’의 ‘보상체계 공정성 제고’ 부분에는 세부 정책 가운데 하나로 ‘혼합진료 금지’와 ‘실손보험 개선’이 제시되었다. 백내장 수술, 도수치료처럼 과잉 진료가 만연한 비중증 영역에 대해 급여(건강보험)와 비급여(손실보험) 진료를 동시에 하지 못하도록 막는 정책이다. 손실보험의 도입으로 비급여 시장이 팽창하면서 병원에 있어야 할 필수의료 인력이 금전적 인센티브가 높은 개원가로 빠져나가는 현상이 벌어지고 있다. 마취통증의학과 전문의가 없어서 병원에선 수술방을 돌리지 못하는데, 동네 골목마다 통증의학과 의원이 우후죽순 생겨나고 있다. 필수의료 분야 의사들에게 돌아가는 보상을 아무리 높여줘도 손실보험에 기반을 둔 비급여 시장이 무한정 커진다면 이 격차를 해소할 수 없다는 판단이 이 정책 패키지에 깔려 있다. ‘혼합진료 금지’의 실제 목적을 두고 여러 논쟁이 일지만, 적어도 현재 보건의료 구조의 문제를 정확히 진단하고 있는 것이다. 물론 정책 패키지에 비어 있는 부분이 있고 이해집단에서는 이견이 나올 수 있다. 그러나 ‘부족하니까 백지화해라’가 아니라 ‘비어 있는 곳을 채워라’고 비판적 지지를 할 만한 수준의, 나름 잘 짜인 구상이라고 생각한다. 지금 이 정책들은 누가 만들고 있는 건가? 보건복지부에서 모두 발표하고 있다. 사무관에서 시작해 과장, 국장으로 올라가며 전문성을 쌓고 역량을 키워온 공무원들이 있다. 그 시간이 축적되면서 한국 보건의료 정책도 점점 성숙해져왔다. 정권과 무관하게 유능한 관료 그룹이 복지부 내에 있다는 뜻인가? 특정 그룹이 있다기보다는 보건의료 체계가 더 이상 그냥 둘 수 없는 임계점에 다다르니 그걸 풀기 위해서 정말 내실 있는 정책을 내놓을 수밖에 없는 시점이 된 것이다. 예를 들어 이번 정책 패키지에 협력 네트워크 보상, 중증·필수 인프라 적자 사후보전 등 ‘대안적 지불제도’를 도입하겠다는 내용이 있다. 가만히 뜯어보면 사실상 ‘총액예산제’에 가까운 성격을 갖는 정책까지 있다. 의사들이 가장 달가워하지 않는 변화가 지불제도(의료비 지급 방식) 개편이다. 지금의 행위별 수가제(의료 행위마다 비용을 지급하는 방식) 아래서는 필수의료 공백 해소, 의료비 상승 억제, 적정 진료 정착 등 보건의료의 문제를 풀 방법이 없으니 개혁적 성격이 다분한 정책도 정부가 더는 미뤄둘 수 없는 것이다. 필수의료 정책 시리즈에서 비어 있다고 보는 부분은 어디인가? 앞서 민간 병원만으로는 필수의료 보장이 임계점에 다다랐다고 설명했는데, 바로 여기가 비어 있다. 민간의료로 커버하지 못하는 영역을 채우도록 공공의료를 키우는 방안이 없다. 전체 의료기관의 95%를 차지하는 시장의존형 의료 공급 구조를 그대로 둔 채 그 안에서 고민하니까 미흡한 정책이 나올 수밖에 없다. (계속) ==================================================================== 출처: https://www.sisain.co.kr/news/articleView.html?idxno=52686 윤석열 의대증원에 우호적인 축에 들어가는 의료관계자와의 인터뷰. 공공의료 건립 의지가 없는 건 비판하는 등 한계는 인정하지만, 의료정책 변화 방향 자체는 높게 평가하는 것 같습니다. 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 카르스님의 최근 게시물
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Warning: Use of undefined constant use_formmail - assumed 'use_formmail' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 605
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 599
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 599
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 600
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 600
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 605
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 609
Warning: Use of undefined constant is_admin - assumed 'is_admin' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 609
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 614
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 616
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/lib.php on line 618
Warning: Use of undefined constant x - assumed 'x' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 612
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 612
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/pb/view.php on line 620
Warning: Use of undefined constant ismember - assumed 'ismember' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 628
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 628
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/view.php on line 640
Warning: Use of undefined constant name - assumed 'name' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 644
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 646
Warning: Use of undefined constant no - assumed 'no' (this will throw an Error in a future version of PHP) in /home/redtea/html/pb/view.php on line 646
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
300977 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
300977 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
300977'> 먹이
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
24/04/12 21:28
300977>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
전형적인 인의협 출신 인사 중 1인의 생각이네요
국립의료원장 자리는 정부 정책에 크게 반대한다면 그만 둬야 하는 포지션이기도 합니다
별다른 통찰력이 엿보이는 건 아닙니다만 그렇다고 뭐 비난까지 할 생각은 없고, 그냥 너무 무게감 줄 것 없이 백가쟁명마냥 커뮤니티나 기사로 한두마디씩 흔히 올라오는 (‘어느 ~~~의 생각’류) 이야기 중 하나라고 보면 될 듯 합니다
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 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 168
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 168
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 168
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 168
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 168
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 168
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 168
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 168
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 168
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
7
국립의료원장 자리는 정부 정책에 크게 반대한다면 그만 둬야 하는 포지션이기도 합니다
별다른 통찰력이 엿보이는 건 아닙니다만 그렇다고 뭐 비난까지 할 생각은 없고, 그냥 너무 무게감 줄 것 없이 백가쟁명마냥 커뮤니티나 기사로 한두마디씩 흔히 올라오는 (‘어느 ~~~의 생각’류) 이야기 중 하나라고 보면 될 듯 합니다
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 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 168
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 168
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 168
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 168
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 168
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 168
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 168
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 168
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 168
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
7
300977>
300977>
