복지국가 보건의료 정책의 정치경제학: 1979년부터 2010년까지 영국의 보수당 정부와 신 노동당정부의 National Health Service 개혁을 중심으로
The Political Economy of Healthcare Policy of the Welfare State: National Health Service Reform by the Conservative and New Labour Governments from 1979 to 2010
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본 논문의 목적은 1979년부터 2010년까지 영국의 보수당과 신 노동당 정부의 NHS 개혁정책 분석을 통해 복지국가 보건의료 정책의 정치경제적 역동성을 고찰하고, 복지정치의 이분법적 논리 재고의 필요성을 밝히기 위한 것이다. 두 정부가 발행한 백서 등 정책 보고서, 전당대회 원고, 법안 등을 분석한 결과, 보수당 정부는 NHS 행정 조직 및 권력 구조를 분권화하고, 기업 경영 원리와 내부 시장 도입을 통해 운영 방식을 개혁하였으며, 신 노동당 정부는 NHS 행정 조직 및 권력 구조의 분권화를 확대하고, 기업 경영 원리와 내부 시장 확대를 통해 운영 방식을 개혁하였다. 두 정부가 상이한 정치 이데올로기에 기반 하여 복지 정책에 대한 시각이 상반됨에도 불구하고, NHS를 유사하게 개혁했다는 분석 결과는 상반되는 두 정치 세력의 복지정치에 대한 기존의 이분법적 접근이 보다 다양한 스펙트럼을 수용할 수 있는 시각으로 수정되어야 함을 시사한다.
Abstract
This research aims not only to examine the political economic dynamics of healthcare policy in the welfare state but also to argue to reconsider the dichotomous perspective of the welfare politics. The research focuses on the issue by analysing the NHS reform carried by the Conservative and New Labour Governments from May 1979 to April 2010. Content analysis shows that the Conservative Government decentralized both the organization of administration and the structure of the power in administration. In addition, the government renewed the way of management by introducing both managerialism and internal market. The New Labour Government extended the decentralization and strengthened both managerialism and internal market. The fact that both governments reformed the NHS by using a homogeneous preference despite adhering to different political ideologies suggests that the dichotomous perspective of welfare politics should be reconsidered.
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