의료서비스산업 선진화를 위한 제도개선과제

윤희숙 / 고영선(Author)


Despite the recent demand for upgrading health services, it is difficult to build consensus on the implications for advancement in the health service sector. In general, the degree of advancement in an industry was measured by the size of its industrial output, however, the advancement of health service should be measured by the responsive capability in which people's demands are met while maximizing their welfare, and allowing them to use quality service with less economic burden.

Under this context, this study investigates regulations that would be needed or should be removed in order to strengthen consumer power and to change the health service market into a more personalized consumer-oriented industry. Then, the study tries to seek measures to improve them.

The study first reviews what has been missing in Korea’s medical system in view of the goal, the maximization of consumer satisfaction. It is found that policies in the sector so far have focused on control-oriented measures and overlooked the existence of market. As a result, the market mechanism of health services today is diagnosed to work improperly. This is mainly because whereas the sector in need of government’s active participation is actually lacking government intervention and the sector in need of entrepreneurial autonomy is overloaded with strict regulations that hinder creative new attempts.

Above all, consumers are not empowered to make proper choices. Without standards of judgment, people are scrambling to large-scale hospitals. Medical institutions focus more on expanding externally than on competing on price and service quality, in other words, distorted competition structure. Not only that, suppliers attempting creative and innovative management, or potential competitors wishing for new entry into the market resort to expedients of bypassing regulations. In this process, they come to frequently practice illegal methods such as skimming of profits.

This study identifies the problems in the regulation environment that cause inefficiency and opacity in the health service industry and then makes suggestions for improvement. For instance, vague regulations with little practical use, such as those related to the establishment of medical institution should be eradicated. This study also reviews areas that the government should actively intervene by establishing clear and strict rules and also be fully responsive. For example, the issue of sharing information on price and service quality of public institutions requires active intervention by the government for the purpose of protecting consumers and activating competitive mechanism. The management of the quality of medical personnel strongly requires the supervisory function of government for the purpose of laying the foundation for consumer choice. As for the sales of pharmaceutical products, it is urgent that the government should expand distribution channels so as to further encourage price competition.

Issue Date
요 약

제1장 서 론

제2장 의료서비스산업의 환경 변화
 제1절 정부 역할의 변화
  1. 의료부문에 대한 정부개입의 목적
  2. 의료서비스시장에서 소비자의 위상
  3. 시기별 정부 역할의 변화
  4. 주요 영역별 정책방향의 변화
 제2절 병원의 위상 변화
 제3절 소비자 중심의 시장 재편
  1. 소비자 지향 비즈니스 모델을 향한 혁신
  2. 소비자 권력과 정보 접근성

제3장 우리나라 의료서비스 공급체계의 특징과 정책환경
 제1절 의료서비스 공급체계의 현황
  1. 우리나라 의료서비스 공급체계의 역사적 연원
  2. 경쟁압력의 상승
  3. 자본수요의 증대
 제2절 의료서비스 시장 관련 규제
  1. 규제의 일반현황
  2. 소비자의 정보 접근성
  3. 보건의료인력 질 관리
  4. 의료시스템의 불투명성과 의약품정책
  5. 가격규제
  6. 보건의료업 개설권 제한
  7. 병상통제정책
 제3절 의료서비스시장의 문제점
  1. 경영혁신과 비즈니스 유형 다양화의 여지 미미
  2. 소비자 지향성의 낙후
  3. 다양한 시장화 시도와 의료법의 마찰

제4장 규제개선의 방향과 예상 효과
 제1절 소비자 능력 강화
  1. 의료기관 정보인프라 구축
  2. 민간보험 관련 정보 접근성 개선
  3. 환자의 의료정보 접근권 강화
 제2절 개설권 규제 완화
  1. 영리법인의료기관 허용
  2. 의료인의 의료업 독점 완화와 복수사업장 허용
  3. 부대사업 제한 완화
  4. 영리법인 약국 허용
 제3절 규제개선의 효과
  1. 소비자 권력 강화를 통한 시스템 업그레이드
  2. 비즈니스 유형 다양화 시도의 허용: 소비자 지향의 경영혁신 증진
  3. 시장규칙 정립과 투명성 제고
  4. 융합을 통한 신산업 발전: 건강관리서비스와 U-health
  5. 산업화 증진의 효과

제5장 규제개선의 보완장치
 제1절 공적의료보장체계 정비
  1. 국민의료비의 개념적 고찰
  2. 개설권 제한 완화가 국민의료비 규모에 미치는 효과 예측
  3. 공적보험의 보장기능 강화
  4. 필수진료과목 보완
 제2절 비영리기관의 역할 부여와 퇴출통로 마련

제6장 요약 및 결론
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