1969년 스웨덴 헌법 개정이후 의료체계의 민영화에 관한 연구
The revision of Constitution in 1969 and the privatization of swedish health care
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초록
본 연구는 정치적 관점에서 스웨덴 의료서비스 개혁의 성격을 분석하는 것이다. 1969년 스웨덴의 헌법 개정은 양원제를 폐지하고 단원제로 전환되었다. 헌법 개정을 통한 의회제도의 변화는 1970년대 중반 이후 사민당의 다수 지지율을 하락하였고 상대적으로 약소정당이었던 우파 정권이 성장하는 계기가 이루어졌다. 신자유주의 성향의 우파정권의 성장은 스웨덴 복지 체제를 변형시키는 발판을 마련하였고 여기의 한축이었던 의료 서비스 역시 민영화라는 신자유주의적 성격의 개혁이 단행된다. 즉 1980년대를 기점으로 의료서비스의 탈중앙화, 민영화 및 시장화가 진행되기 시작한다. 1982년 보건의료서비스 법의 개정, 1982년 사회서비스 법제정 및 2002년 개정, 1991년 신지역정부법, 1992년 공공조달법, 2008년 자유선택법이 제정되고 개정되면서 점점 더 의료서비스의 민영화를 강화시키는 방향으로 나아가고 있다. 헌법 개정 전 스웨덴 의료서비스는 국가 주도의 국유화 성격으로 사민당의 이념이 투여된 시스템이었다. 그러나 헌법 개정 후 우파정권의 집입은 신자유주의 방식은 민영화 전략을 통해 탈중앙화, 탈국유화의 성격으로 전환하고 있다.
Abstract
This study is about the privatization of swedish health care reform after Swedish Constitution revision in 1969 from upper chamber system to one chamber system. At that time, the reform affected the political power the relationship between Social Democratic Party and non-Social Democratic Party especially Liberal Party with neoliberal Philosophy. Before reform, Social Democratic Party had majority representative especially first chamber. This factor affect Social Democratic Party built the Welfare system under universalism, equality and corporatism. However, after reform, Welfare system affected by neo liberal. Sweden’s privatization strategy has been started since the 1980s. At that time the Swedish health service system was monopolied integrated model which all Swedish citizens accessed equivalent services. The aim of this model was that gap between classes are narrowed. But since the 1980s, rigid system due to excessive bureaucracy, inefficiency, and a long wait were raised. In the 1990s, many welfare state healthcare reforms through a strategy for the market implemented. So do Sweden. Sweden government tried to spit between purchaser and provider. This aim is to increase the efficiency and enhance the patient’s access. In 2000s, the Swedish government efforts to expand the rights of patients to medical services. By giving County Council and local government more autonomy, the health care are meet rapidly more patient’s need.
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