박민수‘의사부족조사’‘증원배분정책’둔갑‘이견도찬성'변조

Park Min-soo falsified the ‘doctor short

박민수 ‘의사 부족 조사’에 ‘증원 배분정책’ 둔갑 ‘이견도 찬성’ 변조     

박민수 복지차관이 ‘의사부족 실태 조사’ 용역 연구 결과인 ‘2035년 1만명 의사 부족’ 예상치를 ‘증원 연구’로 변조하고 연도별로 분배하는 ‘증원에 연도별 분배가 최고 상급 정책’에 적용했다.

박 차관은 의사 부족 조사 용역을 증원 정책 고유 결정권으로 둔갑시키며 하위 심의 기구에서 나온 ‘다른 이견’을 두고 아예 정부가 ‘반대가 아닌 찬성 의결 분류’해서 2천명 증원 정책이 결정했다.

박 차관은 13일 의대 2천명 증원에 대해 3개 용역 연구자의 '과학적 방법론'에 의한 연구비 지급후 결과 보고서에 나온 수치를 토대로 “증원 시기·규모·방법 등은 정책적 결정에 따라 정한 것”이라고 정부의 하청 용역에 대해 ‘미세 조정’을 정부의 최고 가치인 상위 정책으로 뒤바꿨다.

복지부는 이날 "보정심은 만장일치로 의결하는 방식이 아니며 심도있는 논의를 진행한 끝에 최종적으로는 안건 의결에 대해 이견이 없음을 확인해 의결했다"고 설명해 ‘반대 의견’에 대해 ‘의결 이견 없음’으로 패쇄 정책 결정을 확인했다.

박 차관이 근거로 내세운 3개 기관 연구 용역은 ‘부족 실태 조사’에 해당되며, ‘의사 증원 연구 용역’과 격차가 크다.

박 차관은 이날 "정부가 참고한 3개 수급추계 보고서 중 KDI 보고서만 증원 규모를 제시했고 해당 연구자는 2024년부터 2030년까지 매해 정원의 5~7%를 단계적으로 증원할 것을 제안한 바 있다"며 "그러나 증원 시기와 규모, 방법 등은 정책적 결정사항이다"이라고 말해, 정부가 ‘내년 2천명 결정’에 ‘밀실 정책 고유 권한’으로 격상했다.

그는 이어 "정부는 앞으로 10년도 남지 않은 2035년에 의사 1만명이 부족해진다는 복수의 과학적 방법론에 의한 연구보고서를 토대로 의대 증원을 결단했다"며 "한국보건사회연구원과 KDI(기재부 산하기관), 서울대학교의 3개 보고서는 객관적 추계 방법을 통해 공통적으로 2035년 1만명의 의사 부족을 예측했고 이에 대한 논의와 검토도 있었다"고 ‘3개 용역 의뢰’에서 ‘정부출연 KDI'만 후미에 증원을 ’보조 첨언‘으로 언급해 애초 연구 용역이 ‘실태 조사’ 의뢰라고 ‘증원’과 완전 분리된다.

박 차관은 ‘의사 부족’ 연구 용역에 대해 "의사 양성에 최소 6년이 걸린다는 점을 감안했을 때 의사인력 확충을 더 이상 미룰 수 없다고 판단했다"며 "2031년부터 2천명씩 2035년 1만명 공급을 위해 2025년에 2천명 증원을 결정한 것"이라며 “더이상 미룰 수 없다고 판단했다”고 말해, ‘인력 확충 시급은 정부 관료 밀실 판단’ 원칙을 확인했다.

복지부는 이날 보도자료로 "6일 회의(보정심)에는 전체 25명의 위원 중 23명이 참석했으며 참석자 중 19명은 2천명 증원에 찬성했고 의사인 위원 3명을 포함한 4명이 반대했다"면서 "반대의 경우에도 규모에 대한 이견으로 증원 자체에는 찬성 의견이었다"고 밝혀, 반대 의견자를 ‘찬성 의견’으로 둔갑 사태로 공식 발표했다.

의사 증원에 대한 정책 결정이 되려면 ‘증원 수치 이견’은 당연히 ‘증원자 2천명 결정 반대’이고, 정부가 제시한 증원 수치 반대는 '증원 정책 반대'로 분류된다.

윤석열 대통령은 9일 기자회견에서 “의료개혁은 우리의 폭발적으로 증가하는 의료 수요를 감안할 때 더 이상 미룰 수 없는 과제”로 밝히면서, ‘의료 수요 폭발적 증가’의 근거를 제시하지 않았다.

이재명 대표는 의료 수요 급격 확대를 통해 국가건강보험 강화체제로 의료보험의 국가검진 확대자인 김윤 의료관리 교수를 비례대료 국회의원으로 영입하고 김 당선자는 ‘2천명 증원 확정’을 거듭 공언했다. 

윤석열 이재명 체제는 10조원 재정 투입의 '국민건강에 의한 의료 총수요 확대' 전략으로 공급우위 조성에서 의사가 행정명령 수단이 됐다.

의대 정원 2천명 사태는 관료의 행정명령 우위 체제의 전형을 보이며 펀드경제의 의료산업이 의료체계 주도자가 되며 '미래 의료 수요 폭발' 이념에 의한  공급우위 전략에서 관료 독재의 '현실 전횡'을 보인다.

박 차관은 2월 27일 CBS라디오에서 “정부는 지역‧필수의료를 살리기 위해 향후 10조원을 투입한다. 의료계가 파업에 나선다면 어떤 국민이 이같은 정책에 동의하나. 합리적으로 생각해 달라”고 10조원 재정투입의 공급우위 전략체제를 밝혔다.

박 차관은 의사 수가 늘면 의료비가 증가할 것이라는 경제학의 ‘유인수요이론’에 대해 “이미 학문적으로 사실이 아니라고 판명됐다”며 “의사 수가 늘면 의료비가 증가할 것이라는 이론은 우리나라를 포함한 선진국에서 실증한 결과 상관관계가 없다고 결론이 났다. 의료비 증가에 영향을 주는 것은 고령화와 소득수준”이라고 밝혔다.

박 차관은 이날 2천명 증원 근거로 보건사회연구원과 서울대 연구 결과라며, 현재 의사 수가 5,000명 부족하고 현 상황 유지하면 2035년까지 1만명이 더 부족해져 총 1만5천명 부족 사태라고 밝혔다.

그는 이날 “2025년부터 2천명씩 증원하면 2031년부터 졸업생 배출해 2035년이면 1만명이 확충되고, 나머지 부족한 5천명은 인력 재배치와 수가 인상 등을 통해 메우겠다”고 복지관료가 ‘의대 정원 배분 정책 결정’ 지배 구조를 처음으로 공표했다.kimjc00@hanmail.net       

  

Park Min-soo falsified the ‘doctor shortage investigation’ by disguising it as ‘increased personnel distribution policy’ and ‘dissenting opinions are also in favor’.

Vice Minister of Health and Welfare Park Min-soo changed the estimate of 'a shortage of 10,000 doctors in 2035', which was the result of a 'doctor shortage survey', into a 'study on increasing the number of doctors' and changed it into 'an annual distribution as an increase in the number of doctors, the highest policy'. .

Vice Minister Park transformed the service to investigate the shortage of doctors into a unique decision-making authority for the expansion policy, and the government decided on the policy of increasing the number of personnel by 2,000 people by ‘classifying the resolution in favor rather than against’ in response to the ‘different opinions’ that emerged from the lower-level deliberation organizations.

Regarding the increase in medical schools by 2,000 students on the 13th, Vice Minister Park said, “The timing, scale, and method of increasing the number of medical students were decided based on policy decisions,” based on the figures in the report on the results of the research funds paid by the three contract researchers based on the “scientific methodology” of the three contract researchers. 'Fine adjustment' for subcontracted services was replaced with a high-level policy that is the government's highest value.

The Ministry of Health and Welfare explained on this day, "Revision review is not a unanimous decision, and after in-depth discussion, we ultimately confirmed that there was no disagreement on the resolution of the agenda and decided on it." The 'dissenting opinion' was dismissed as 'no disagreement in the resolution'. Confirmed the policy decision.

The research services of the three institutions cited by Vice Minister Park as a basis correspond to the ‘survey of shortages’, and there is a large gap with the ‘research services to increase the number of doctors’.

Vice Minister Park said on this day, "Of the three supply and demand forecast reports referenced by the government, only the KDI report presented the scale of increase, and the researcher proposed a gradual increase of 5-7% of the number of personnel each year from 2024 to 2030." “However, the timing, scale, and method of increasing the number of personnel are a policy decision,” he said, and the government upgraded the ‘decision on 2,000 personnel next year’ to a ‘secret policy inherent authority’.

He continued, “The government has decided to increase the number of medical schools based on research reports based on multiple scientific methodologies that show that there will be a shortage of 10,000 doctors in 2035, which is less than 10 years away.” He added, “The Korea Institute for Health and Social Affairs and KDI (an affiliate of the Ministry of Strategy and Finance) , Seoul National University's three reports commonly predicted a shortage of 10,000 doctors in 2035 through objective estimation methods, and there were discussions and reviews on this,” he said, adding that in the ‘three service requests’, only the ‘government-funded KDI’ was the last to increase the number of doctors. By mentioning it as an 'auxiliary comment', the original research service was a 'fact-finding survey' request, which is completely separate from the 'increase in troops'.

Regarding the 'doctor shortage' research service, Vice Minister Park said, "Considering that it takes at least 6 years to train doctors, we decided that the expansion of the doctor workforce could no longer be postponed." He said, “We decided to increase the number of employees by 2,000 in 2025 for supply purposes,” and “We decided that we could not postpone it any longer,” confirming the principle that “the urgent need for manpower expansion is determined behind closed doors by government officials.”

The Ministry of Health and Welfare said in a press release that day, "23 out of 25 members attended the meeting (revision review) on the 6th. 19 of the attendees were in favor of increasing the number of personnel by 2,000, and 4, including 3 members who were doctors, were against it." In this case, the opinion was in favor of the increase itself due to differences of opinion on the scale,” he said, and officially announced the situation by disguising the opposing opinion as a “favorable opinion.”

In order to make a policy decision on increasing the number of doctors, ‘disagreement on the number of troops to increase’ is naturally classified as ‘opposition to the decision to increase the number of doctors by 2,000’, and opposition to the number of increases presented by the government is classified as ‘opposition to the policy of increasing the number of doctors.’

At a press conference on the 9th, President Yoon Seok-yeol said, “Medical reform is a task that can no longer be postponed given our explosively increasing medical demand,” and he did not provide any basis for the ‘explosive increase in medical demand.’

Representative Lee Jae-myeong recruited Kim Yoon, a medical management professor who expanded the national health insurance screening system, as a proportional member of the National Assembly through a strengthening system for national health insurance through a rapid expansion in medical demand, and President-elect Kim repeatedly pledged to ‘confirm an increase of 2,000 people.’

The Yoon Seok-yeol and Lee Jae-myeong regime's financial strategy of 'expanding the total demand for medical care through public health' created a supply advantage and doctors became a means of issuing administrative orders.

The medical school quota situation of 2,000 students is a typical example of a bureaucratic system of administrative order dominance, with the medical industry taking the lead in the medical system, and the 'realistic despotism' of bureaucratic dictatorship in the supply superiority strategy based on the ideology of 'exploding future medical demand'.

Vice Minister Park said on CBS Radio on February 27, “The government will invest 10 trillion won in the future to revive local and essential medical care. If the medical community goes on strike, what kind of people would agree to such a policy? “Please think rationally,” he said, revealing a supply-dominant strategic system for financial investment.

Vice Minister Park said about the ‘incentive demand theory’ in economics that medical expenses will increase as the number of doctors increases, “It has already been academically proven to be untrue,” and “The theory that medical expenses will increase as the number of doctors increases is a result of verification in advanced countries, including Korea. It was concluded that there was no correlation. “What affects the increase in medical expenses is aging and income level,” he said.

Vice Minister Park said on this day that the basis for increasing the number of doctors by 2,000 was the results of a study by the Korea Institute for Health and Social Affairs and Seoul National University, and that there is currently a shortage of 5,000 doctors, and if the current situation is maintained, there will be an additional shortage of 10,000 doctors by 2035, for a total shortage of 15,000.

He said on this day, “If we increase the number of students by 2,000 from 2025, we will produce graduates starting in 2031, increasing the number of students to 10,000 by 2035, and the remaining 5,000 students will be filled through personnel reallocation and fee increases,” and welfare officials said, “Medical school quota distribution policy.” 'Decision' governance structure was announced for the first time.

Medical fund, medical economy, supply advantage, hard-line conservatism, Kim Yun, secret room policy, Park Min-soo, Ministry of Health and Welfare, fact-finding survey, Yoon Seok-yeol, medical school increase, medical reform, doctor shortage, Lee Jae-myeong