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의료보험에 대한 사회적 인식 : 국내 주요일간지 기사를 중심으로

의료보험에 대한 사회적 인식 : 국내 주요일간지 기사를 중심으로
Other Titles
(The) social understanding on medical insurance : through the analysis of newspaper articles
Issue Date
연세대학교 보건대학원
[한글]국민 개개인의 예측할 수 없는 의료수요를 적시에 큰 경제적 부담없이 충족시키고자 사회보험 성격의 의료보험이 실시된지 7년이 되었다. 제도의 필요성을 자각하고 그 시현을 위한 국민적 노력이나 투쟁의 경험이 별로 없는 상태에서 1970년대의 급격한 소득향상과 경제 구조상의 문제 등 정치 경제 사회적 여건에 따라 정부에 의해 결정 실시된 의료보험제도는 수용태세의 미비와 시행가능자에 대한 우선 적용에 따라 제도적 문제점들이 노정되었다. 이러한 시점에서 민주주의의 목탁이며 제4의 권력인 신문은 사회정의와 인도주의에 입각하여 의료보험에 대해 어떻게 계도하여 왔으며, 의료보험제도가 사회의 거울인 신문에 어떻게 투영되었는가를 보는 것은 곧 의료보험의 사회적 인식으로 볼 수 있는 바 1976년부터 1982년까지 6개 중앙 일간지에 게재된 의료보험 관련기사의 전부인 678건을 발췌, 분석한 결과는 다음과 같다. 1. 의료보험 자격관리, 의료보험급여, 의료보험재정, 의료공급의 기사 구성비는 2:3:1:4로서 급여와 편익에 치중되었다. 2. 재정과 공급의 게재빈도는 연도별로 증가하고 급여는 빈도가 낮아지며 관리기구 문제에 관심이 증대되었다. 3. 1면, 2면 사회면에 82.6%가 집중, 게재되었는데 크기는 평균 5.9단이며, 정부발표 42.5%, 학계 및 단체 10.3%, 취재 32%, 사설 15.2%(103건)으로 매 5.6건에 1건씩 사설로 게재되었다. 4. 계도적 기사는 49%이고 이중 긍정과 중립이 57.2%, 부정의 태도가 42.8%이었다. 5. 제도 전반적 관점의 기사는 22.6%이고, 고용관계 측면 55.6%, 비고용관계 측면 13.4%, 기타는 8.4%였다. 위의 사항을 종합하면 급여 중심의 게재성향을 보였고 권리나 의무의 인식제고는 거의 없었으며 내용중 이익집단의 이해관계 및 대중관심사에 편중되어 사회정의 구현, 소외된 소수의견의 반영이 불충분했다고 판단되므로 의료보험의 사회적 인식이 올바르게 되진 못 했다고 생각된다.
[영문]The medical insurance scheme was implemented in 1977 by way of social insurance system by which the mass of people have been made accessible to medical care with less financial burden. There were needs and conflicts originated in the web of socio-economic, and political conditions that had been fabricated in the 1970's, which were economic development versus difficulty of access to medical care, inequality imbedded between the rich versus the poor, no communication to secure peace between south and north Koreans, etc. Medical insurance, it shall be assumed, is necessary to provide a prerequisite for a certain eligibility procedure and performance of exercising duty as a right as prescribed in the enactment. The government went ahead to adopt medical insurance scheme with fewly careful consideration of keen need and due conflicts, and so the present medical insurance scheme has been politically oriented and pushed forward program, and therefore, created many issues and problems. Major issues or problems among them were as follows; 1) lack of full understanding of medical insurance by the people in general, 2) Few coverage far self-employed population, 3) Dual medical fee system (insurance and custom), 4) Maldistribution of medical resources, 5) Ineffective management system of medical resources. The prime objective of this study is to analyze and explain how newspaper had conducted the lead in the sphere of social justice and humanity sake as well as popular opinion on medical insurance. The other words, how it had taken the lead as social mirror reflected to opinion leaders and the role as played democratic forces. Total of 678 articles on the subject of medical insurance and related topics that had appeared in the 6 daily newspapers during the period of 1976 to 1982 are analyzed through content analysis by categories, and the result shows as follows: 1. According to the 4 elementary categories, the ratio showed approximately as follows: coverage in relation to eligibility : 20%, benefit as the social provision of M.I. : 30%, financing through contribution, etc. : 10%, provider related to benefit delivery : 40%. 2. Yearly tendency demonstrated was as such: financing and provider were on the increase, whereas benefit was on the decrease gradually, and administrative system shows growing tendency recently. 3. Total of 82.6% in number appeared in the 4 definite pages, 1st, 2nd, 7th, & 11th Average number of column per article was 5.9 columns. The sources were from government : 42.5%, scholars & sued group concerned : 10.2%, news gathering : 32.0%, editorial : 15.3%. The number of editorial were 103 which meant that 1 from emery 6 had been treated to one editorial. 4. 49% out of total articles showed were instructive (guiding) nature in contents, among which 57.2% was on the positive or neutral ground to the enforcement of medical insurance programs and 42.8% was on the negative ground. 5. According to view-points by medical insurance types, it showed as follows: 22.6% of articles dealt with matters in general aspect, 55.6% on the employment relationship, 13.4% on the self-employed aspect, 8.4% on others related to absurdities, etc. The overall results proved that newspapers tended to carry articles mainly subjected benefits and convenience of the insured, but did take few active interests in the enlightment of the people in leading the public thinking of rights or duties in relation to medical insurance. Most of articles had reported conflicting interests of pressure groups concerned and interests of the public concentrated to one side. It is, therefore, observed that no active guiding extorts were made to realize social justice nor played the role of spokesman for the minorities. It might be right to conclude that newspapers did not play good role in making covered group or people understand what it ought to be, and right and hopeful understandings on medical insurance seem not to be infiltrated into the covered or entire population.
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2. 학위논문 > 4. Graduate School of Public Health (보건대학원) > 석사
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