This study is to analyze the change of the health insurance policy in the 1970s in relation to social welfare discourse. The public health care in Korea was in very poor condition around the first amendment of the National Health Insurance Act in 1970. Furthermore, due to the introduction of new medical technology, increasing number of big hospitals participating in the medical market, inflation, and other factors, medical expenses skyrocketed and made it hard for ordinary people to enjoy medical services. Accordingly, the social solution to the problem of medical expenses which an individual found hard to deal with became of demand. And as the way to the solution, it was inevitable to consider the introduction of health insurance as social insurance. In this condition, Park regime began to stress the social development from the 1960s. It was to aim to settle various social problems triggered by the rapid industrialization in the 1960s through social development as well as economic development. As the social development was emphasized, the matter of social welfare appeared of importance and led to the first amendment of the National Health Insurance Act in 1970. However, it was impossible for Korean government to enforce a nationwide health insurance. The key issue was how to fund it. Park regime was reluctant to use government fund; it was also hard to burden private companies. Even while the health insurance policy was not determined yet for this reason, the social demand for health insurance became large and large. In particular, in the midst of the first "Oil Shock" which gave a big blow to people's living condition from the late 1973, some reported issues in relation to health service, such as hospitals' rejection of the poor, became a big problem. Coupled with the social demand for a health insurance system, the changes occurred within the medical community was also important. Most of all, hospitals was facing the decrease of the effectiveness of their medical facilities. Therefore, they began to see health insurance as a means of developing potential demand for medical service. In addition, the business world, which already expanded their own corporate welfare for employees from the early 1970s, sharing the idea that it was impossible to keep the issue of public health insurance unsolved, showed an enthusiastic attitude. These factors finally enabled Park regime to adopt the public health insurance system. Likewise, it is critical to understand the establishment of the public health insurance system in Korea through pursuing the process to it. What matters is the discoursive changes as well as the changes in social condition around the establishment, not merely the policy changes per se. Then most people, including decision makers in Park regime, thought of social welfare as a privilege developed countries. Thus, in the 1970s when unbalanced industrialization brought about widening gap between social classes, the employment of a social welfare policy could be recognized as a symbol of an escape from backwardness. In fact, with the introduction of the national health insurance in the 1970s, Park regime could fortify the material fundamental of a social welfare discourse which would be mobilized to strengthen the dichotomous discourse of developedness and backwardness and to dump the social crisis caused by Park regime's industrialization drive on the next generation.
Health Policy/economics/*history ; History, 20th Century ; Humans ; National Health Programs/*history ; Public Health/economics/history ; Social Welfare/economics/*history

Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature.
*Bioethics/history ; *Ethics, Medical/history ; Health Policy ; History, 20th Century ; History, 21st Century ; Humans ; Republic of Korea

This article analyzes the social transformation of Korea's health care policy in the twentieth century from a historical perspective. The whole period under the research is divided into four stages. In the first stage(1900-1945), two major health care policies, public hygiene and population control, were a part of political strategy for consolidating Japanese colonial dominion over Korea. The second stage(1945-1960) is characterized by the division of Korean peninsula and Korean war that resulted in the vicious cycle between massive poverty and social disease. In the third stage(1961-1991), military governments considered the health care system as a 'carrot' for enhancing national security and reinforcing legitimacy of the regime. In the final stage(1992-1999), the state and civil society have been influential agents in shaping forms and contents of health care policy, with the organized medicine relatively neglected. Globalization will have more influence on the arena of health care policy in which three agents would have to negotiate one another. In addition, the organized medicine will have to consider a variety of non-governmental organizations(NGOs) as an inevitable counterpart of policy-making process. in harmonizing the conflicts between public deliberation and professional interests. In the next century, health care policy, along with social welfare, environment and labor policy agendas would constitute a health-related policy regime in which all the participants have to accomplish not medicalization of life but socialization of health care and to diminish the inequity in health among a variety of social class.
English Abstract ; Health Policy/*history ; History of Medicine, 20th Cent. ; Korea ; *Medicine ; Public Health Administration/*history

The purpose of this article is to analyze the two early health care reform groups: the American Association for Labor Legislation(AALL), the first organization to try to initiate compulsory health insurance in the U.S., and the Committee on the Costs of Medical Care(CCMC), a self-formed committee to study the economics of medical care. By viewing health policy from a historical perspective, we can find a variety of possible alternatives that would have been implemented in different place and time. Unlike positivistic studies on health policy whose only concern is with successful programs, the history of health policy is interested not only in success but also in failure of policy. Reformers from the late 1910s through early 1930s recognized health insurance as a medical issue not as a welfare issue. As long as health insurance belonged to medical domain, policy on health insurance remained separate from public policy. If so, who analyzed and decided the policy? This article argues that social reformers in this period should have tried to launch health insurance not from the front of medical care but in the field of public welfare. This shift in the direction of health care reform would inevitably have caused changes in the strategies accepted.
Comprehensive Health Care/history ; English Abstract ; Health Care Costs/*history ; Health Care Reform/*history ; Health Policy/*history ; History of Medicine, 20th Cent. ; Insurance, Health/*history ; United States

The state-running medical institutions which had been instituted in the earlier period of the Chosun dynasty substantially downsized during the reconstructing process after the major wars with Japan and Qing dynasty. The downsizing was mainly due to the malfunctioning public financial system; but it was also due to the growth of the private medical market. The growth of the private medical market reoriented the focus of the public health system of the Chosun dynasty from providing treatment for every minor disease to providing the more efficient policy against epidemic. Hwal-in Seo (a temporary local public health center established for epidemic) became a new core of the dynasty's health policy under the phrase of "Ae Rye (saving the rituals)." As the changes of the dynasty's public health policy, the growing private medical market had been admitted into the public domain. Chosun government once had declared Sa Yak Gye (a private mutual-aid group for medicine) illegal and prohibited the private groups to be organized. Instead, with the policy change mentioned above, the government tried to support the private mutual-aid group for medicine while forbidding sales of fake medicine, restraining rise of price of medicine. Especially the Do go merchants often caused the sudden rise of price of medicine by bulk purchasing. Medical practice was reassessed as the period when it was considered as one of the lowest professions had been over. Although the Yangban class still refused to be a professional medical practitioner themselves, they also well understood the value of medicine as a field of study to save human and dismissed negative perception on medicine. Medicine as a field of study and medical practice, which had been underestimated under the ruling system influenced by the Song Confucianism and the status system of the Chosun dynasty, faced a new era. The whole society guaranteed more free practices of the medical practitioners and they were recognized for their works. With the change of social environment, the government officials gradually realized needs to discuss how they could educate and recruit medical practitioners to provide advanced medical treatment and what provisions they had to legislate to ensure the stable supply of the medicine. It is certain that the transformation developed in the medical environment and the changes of the public health policy up to 18th century Chosun dynasty accompanied the emergence of the commercial society. However, the overall social urge was still not enough to induce the actual law-making process. The change of the public health policy and the growth of the private medical market were surely the evidence of the transforming Chosun society; at the same time, they also revealed the immaturity of the medical environment which was not able to lead new health policies.
Health Policy/history ; History, 16th Century ; History, 17th Century ; History, 18th Century ; Humans ; Korea ; Medicine, Korean Traditional/*history ; Private Sector/*history ; Public Health/*history ; State Medicine/history

After graduating from Severance Medical College in 1916, Chang Sei Kim went to Shanghai to work as a missionary in a adventist hospital. The establishment of the Korean Provisional Government led him to participate in the independence movement. Educating nurses to assist the forthcoming war for independence, he seemed to realize the fact that the health of Koreans would be a key factor for achieving independence. He left for the U.S. to conduct comprehensive research on medicine. Chang Sei Kim was the first Korean to receive a Ph. D. degree of Public Health, graduating from the Johns Hopkins School of Hygiene and Public Health in 1925. He then gained an opportunity to work for Korea as a professor at Severance Medical College. His objective was the 'Reconstruction of the Korean People In Terms of Physical Constitution.' He pointed out that Koreans' weak state of health was a major reason for Korea's colonization. To gain independence, he emphasized that the Korean people should receive education on public health in order to improve the primitive conditions of sanitation. There is little doubt that Chang Sei Kim's ideas developed Heungsadan's views on medicine in terms of its stress on cultivation of ability, especially considering the fact that he was a member of the organization. As a member of the colonized who could not participate in the developing official policy, Chang Sei Kim was not able to implement his ideas fully, because an individual or a private organization could not carry out policy on public health as large a scale as the government did. Never giving up his hopes for Korean independence, he rejected requests to assume official posts in the Government-General. That was why he was particularly interested in the Self-Governing Movement in 1920s Korea. If the movement had attained its goal, he might have worked for the enhancement of sanitary environment as a director of Sanitary Department. His application for funding to establish a hygiene laboratory in Korea was rejected by Rockefeller Foundation, as the policy of foundation was to finance only government institutes, not private ones. Resigning his position at Severance Medical College in 1927, Chang Sei Kim went to Shanghai to work as a Field Director in the Council on Health Education. The council was affiliated with the Rockefeller Foundation and was founded to ameliorate the hygienic situation in China. He was well fitted to the job, because China, like Korea, shared the aim to achieve independence by promoting better health for its people and because he could be appointed as a public officer which could not happen in colonial Korea. To solve the ever-serious problems with tuberculosis in China, he went again to the U. S. to conduct research and raise money for the establishment of a sanitarium. Chang Sei Kim passed away there in 1934 at the age of 42.
Public Health Practice/history ; Public Health Administration/*history ; Korea ; Japan ; Humans ; History, 20th Century ; Health Policy/history ; Health Education/history ; Colonialism/history

In the 1950s and 1960s, Korea overcame the aftermath of the war and laid the foundations for modernization of economy and professionalization of medicine. The National Medical Services Law, enacted in 1951 was the first medical law to be legislated since the establishment of the Republic of Korea. The law provided a medical system for the traditional Korean medical practitioners, activated opening of hospitals through report-only system and prohibition of interference in medical practice, and facilitated mobilization of the doctors by the government. The Medical Law, legislated in 1962 by the Park Jong-Hee administration contained practice license system, regular practice reporting system and practice designation, thereby strengthening the government control on the medical practitioners, inducing professionalism and high-quality of medical practitioners and abolished unlicensed medical practitioners such as acupuncturists, moxa cauterists and bone setters. The Medical Assistant Law of 1963 was introduced so that medical examination and assistance could be carried out under supervision of professional doctors. To reduce areas without healthcare system, region-specified medical practitioners got licensure and a community doctor system was organized. However, due to expensive medical fees in comparison to economic status and medical needs of patients, shortage of doctors, low accessibility to hospitals led to the prevalence of illegal medical practice by unlicensed practitioners. Absence of national budget or policy on the health care system and the American-style noninterference medical system were other factors causing the situation. Government, Korean Medical Associations and Korean Dental Association tried, without success, to exercise control over the unlicensed medical practice. President Park Jong-Hee had to introduce a special law concerning the health-care related crimes with life sentence as the highest penalty. While the government put modernization before social welfare, operated on a policy of state-controlled medical care system, and doctors achieved specialization system similar to that of the United States, the public had to suffer, being treated by unlicensed medical practitioners. Inevitably, the need for a national medical practitioner supply plan and a policy to support health service was raised.
Health Policy/history ; History, 20th Century ; Humans ; Legislation, Medical/*history ; Licensure/*history ; Private Sector/history ; Public Health/history ; Republic of Korea ; State Medicine/*history

After the liberation from Japanese colonial rule in August 1945, the United States of America established Military Government in Korea(USAMGIK) south the 38th parallel. The public health and medical policy of the USAMGIK was defined by the USA's general policy toward Korea, and followed national interests of USA after the end of the World War II. The basic objectives of the early occupational period were two; the protection of the occupation troops, the prevention of acute epidemic diseases and unrest in the populace. However, after the switch of occupation policy to the establishment of pro-American anti-Communist nation in Korea since June 1946, the basic objectives turned into 'the establishment of the influence of American medicine in Korean medical system.' During the occupation period, USAMGIK trained several pro-American right - wing doctors who formed the clique of policy makers in the independent government, and established many quasi - American public health and medical systems in Korea.
Colonialism/*history ; English Abstract ; *Government ; Health Policy/*history ; History of Medicine, 20th Cent. ; Korea ; *Medicine ; Military Medicine/*history ; *Politics ; Public Health/*history ; United States ; War/*history

1793 Yellow fever in Philadelphia was the most severe epidemics in the late 18th century in the United States. More than 10% of the population in the city died and many people fled to other cities. The cause of yellow fever in the United States had close relationship with slaves and sugar in Philadelphia. Sugarcane plantation had needed many labors to produce sugar and lots of Africans had to move to America as slaves. In this process, Aedes aegypti, the vector of yellow fever had migrated to America and the circumstances of ships or cities provided appropriate conditions for its breeding. In this period, the cause of yellow fever could not be established exactly, so suggestions of doctors became entangled in political and intellectual discourses in American society. There was a critical conflict between Jeffersonian Republicanism and Federalism about the origin and treatment of yellow fever. Benjamin Rush, a Jeffersonian Republican, suggested urban sanitation reform and bloodletting. He believed the infectious disease happened because of unsanitary city condition, so he thought the United States could be a healthy nation by improvement of the public health and sanitation. He would like to cope with national crisis and develop American society on the basis of republicanism. While Rush suggested the improvement of public health and sanitation, the city government of Philadelphia suggested isolation of yellow fever patients and quarantine. City government isolated the patients from healthy people and it reconstructed space of hospital. Also, it built orphanages to take care of children who lost their parents during the epidemic and implemented power to control people put in the state of exception. Of course, city government tried to protect the city and nation by quarantine of every ship to Philadelphia. Control policies of yellow fever in 1793 showed different conflicts and interactions. Through the yellow fever, Jeffersonian Republicanism and Federalism had conflicted in politically, but they had interactions for control of the infectious disease. And with these kinds of infectious diseases policies, we can see interactions in local, national and global level.
Government Regulation/*history ; Health Policy/*history ; History, 18th Century ; Humans ; Philadelphia ; *Politics ; Yellow Fever/epidemiology/etiology/*history/*prevention & control

Acquired Immunodeficiency Syndrome ; prevention & control ; China ; Health Plan Implementation ; History, 20th Century ; History, 21st Century ; Humans ; Internationality ; Public Policy ; history ; Quality Control