韓國醫療改革政策的敘事框架

The Framing of Medical Reform Policy in Korea

本文目的在探討韓國自盧武鉉政府至朴槿惠政府，三任總統期間醫療改革政策推動與反對運動的框架（frame）。本文透過政府的發言與白皮書、政策文件，以及社會運動者發出的宣言、聲明、新聞稿等文件進行分析後指出，韓國自盧武鉉總統開始，在醫療體制上提出了「先進化」框架，但民間則以反「民營化」框架加以回應。韓國政府在面對新自由主義全球化的浪潮，國家經濟層面競爭加劇之下，以國家發展為由推出「先進化」框架，該框架超越了左右不同政黨的主張，並將傳統左右立場的對立轉為技術性的科技管理，引入了國家競爭的邏輯，避開公衛改革關心的階級與不平等議題。而民間則提出反對醫療走向產業的「民營化」框架以爭取認同。本文以「先進化」與反「民營化」二個框架，說明韓國在醫療改革上以「先進化」做為新的框架，在全球化時代出現的現象，並說明韓國政府在醫療體系改革的政策競逐上，並無明顯的政黨差異的原因。

In the last decade, the South Korean government has attempted to introduce health system reform, but encountered difficulties. This study examines how the reform issues are framed by the Korean government and by the civil society. I used government documents, white papers, declarations, presidents' speeches, press releases, and position papers to identify the main frames of both sides. Government's descriptions of the health system reform involved references to 'national development' and 'advancement'. Government presents the medical sector as a driving force of economic growth, which is essential to increase competitiveness in the era of globalization. However, the civil society organizations used the frame of anti-privatization to refuse government's reform policy. This article discusses the two competing frames in various health policies in Korea.