초청논단 : 보건의료분야의 선진화를 위한 정책 방향

이규식 ( Kyu Sik Lee ) 한국병원경영학회 2008 병원경영학회지 Vol.13 No.1

In the shortest period of time, we achieved both industrialization and democratization. We also achieved good performance in health care sector. Whole population are covered by health insurance since 1989 and health outcomes, such as infant mortality, life expectance show good level. However, health care system has several problems, rapidly increasing rate of health care expenditure, dissatisfaction of both consumers and suppliers. Current health care system does not reconcile with market competition principle. Causes of these problems originated from 1977 paradigm which was formed to expand health insurance to whole population within short period. Dominant assumption of 1977 paradigm is to assure equitable access of health care by government`s command and control. We urgently demand to reform the 1977 paradigm to suitable in 21th century. Our economy entered into a road to advancement. We have concerns how President Lee`s administration reform health care system to harmonize with economic development and to achieve advancement in health care sector.

목조문화재의 원형보존을 위한 충해 방제방안

이규식,정소영,정용재,Lee, Kyu-Sik,Jeong, So-Young,Chung, Yong-Jae 국립문화재연구소 2000 保存科學硏究 Vol.21 No.-

The cultural properties are damaged by various causes according to the characteristics of material, the condition of preservation, and the period of time. Especially, biodeterioration makes lots of damages in organic properties than inorganic ones. The damages of wooden cultural properties by insects usually are caused by the three orders; Isoptera, Coleoptera, and Hymenoptera. As the result of investigation on the state of 141 buildings of wooden cultural properties in 1999, some of them were damaged by many kinds off actors; wasp, powder post beetle, cigarette beetle, termite, decay, and physical cracking. And it was found that the patterns of damages were related to species-specific habits of insects. There are several methods of pest control for the prevention of wooden cultural properties from damages caused by insects. Those are as follows; physical control, chemical control, biological control, and integrated pest management. When insects and fungi were detected at the wooden buildings, the fumigation is best treatment to stop biodeterioration. And then, wood materials also need to be treated with insecticidal and antiseptic chemicals to avoid a reinfestation, because the fumigant is volatile. The six commercial chemicals which are applied to the insecticidal and antiseptic treatment of wooden cultural properties were purchased to test their abilities. According to the comparative results of efficacy of them in laboratory, chemical D showed excellent efficacy in all items, including antiseptic and termiticidal items. The goal of these pest controls is to protect wooden buildings from insects and microorganisms. The most effective method used currently is chemical control(fumigation, insecticidal and anticeptic chemical treatment), but it has to be treated periodically to control pest effectively. Recently environmentally-friendly control methods such as bait system or biological treatments are replacing traditional barrier treatments using large amounts of chemicals. Especially, termite is a social insect which makes a colony. Although a building with fumigation treatment is safe for a while, once attacked building has a risk of damage by reinfestation of termite. Therefore, to control termites from damaged building, the entire colony including reproductives(queen and king) and larvae around buildings must beeliminated. Bait system can be used as a preventive measure in early detection of them through termites colony monitoring and baiting. It would be the most effective for termite control if bait system would be used together with the chemical controls.

출토 인골의 유전자분석-나주 복암리 3호분 옹관 인골을 중심으로

이규식,정용재,한성희,이명희,한면수,최동호,Lee, Kyu-Sik,Chung, Yong-Jae,Han, Sung-Hee,Lee, Myong-Hee,Han, Myun-Soo,Choi, Dong-Ho 국립문화재연구소 1999 保存科學硏究 Vol.20 No.-

We have analyzed the allele and genotype frequencies from 10 fractions of ancient human skeleton in 3 pieces of Jar coffin excavated from Naju Bokamni3rd tumulus by PCR amplification, high resolution polyacrylamide gelelectorphoresis and silver staining. We could isolate human genomic DNA from 3 bone fractions but the rest of them could not be used as materials due to being decayed. We could detect sex determination as male and 3 genotypes of STR system, HUMTHO1, HUMTPOX and HUMC5F1PO from the bone fraction of left side in Jar coffin 3 and see the slightly reaction suggesting the sex as male from the bone fraction of the left side in Jar coffin 2 and female from the right side in Jar coffin 3.We have also analyzed the genotype frequencies of mitochondria from the bone fractions of the left side and the right side in jar coffin 3, respectively. From the result of indetifiying at nucletide position between 16018 and 16378of the base of hyper variable region(HV1) in the control region, We can presume that the both bones have the same maternal inheritance.

제6주제 : 국민건강증진기금사업 10년 성과

이규식(Kyu-sik Lee) 한국보건교육건강증진학회 2005 한국보건교육·건강증진학회 학술대회 발표논문집 Vol.- No.-

There has been 10 years since The Health Promotion Act was legislated. The government began to establish a health promotion fund on the basis of Health Promotion Act in 1995, and to manage and operate the fund from 1998. It is evaluated that health promotion program have had various outcomes in many aspects. First, there has been growing awareness of the impotance of health promotion through the establishment of Health Plan 2010 and the effort to actualize the Plan. Second, the importance of securing health equity and identifying health determinants have been recognized during the planning process of Health Plan 2010. Third, the health promotion program have mainly focused on improving healthy life style of the population. As a result, desirable health behavior change of the population could be expected from the result of 2005 National Health and Nutrition Survey. Fourth, public health centers began to play a crucial role in implementing health promotion programs, and began to build infrastructure for health promotion programs. Fifth, the outcomes of health promotion programs by public health centers and private health organizations have been increasing. Finally, training for health promotion personnel and their participation in the program could be the foundation for the higher level of outcome achievement from the health promotion programs. Important challenges for future health promotion would be identification of the determinants and risk factors of health in Korea, establishment of local health promotion plan, building infrastructure for health promotion, creation of specific action model by public health center, development of diverse health promotion programs and health promotion program for the elderly, conducting research for evidence concerning major factors reducing the need for health care through prevention disease activities, and establishment of evaluation and feed back system for health promotion programs.

초청논단 : 건강보험의 지속을 위한 개혁과제

이규식 ( Kyu Sik Lee ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.4

We achieved both industrialization and democratization during the shortest period in the world. We also achieved good performance in national health insurance: universal coverage, solidarity in financing, equitable access of health care. However, national health insurance system has faced the problem of sustainability: various expenditure and financing problems. The problem of sustainablity has two facets of economic sustainability and fiscal sustainability. Economic sustainability refers to growth in health spending as a proportion of gross domestic product(GDP). Rapid increasing rate of health spending exceeds the growth rate of domestic product. Growth in health spending is more likely to threaten other areas of economic activity. Concern on fiscal sustainability relates to revenue and expenditure on health care. Health care financing face demographic and technical obstacles. Democratic obstacle is aging problem. Technical obstacle is collection of contribution. Expenditure of health care has various problems in benefit structure and efficiency of health care system. In this article, I suggest several policy reforms to enhance sustainability: generating additional revenue from value added tax, changing method of levying contribution, increasing efficiency of health care system by introducing the competition principle. restructuring of benefit scheme of health insurance. contracting with health care institutions to provide health care services.

네덜란드의 의료개혁에 관한 연구 -관리된 경쟁모형-

이규식 ( Kyu Sik Lee ),정기택 ( Kee Taig Jung ),김철중 ( Chul Joong Kim ) 한국사회보장학회 2008 사회보장연구 Vol.24 No.4

노령화와 의료보장 : 공적 , 사적영역과의 역할분담을 중심으로

이규식(Kyu Sik Lee) 한국사회보장학회 1993 사회보장연구 Vol.9 No.-

N/A

특별기고 : 한국의 의료개혁과 향후과제

이규식(Kyu Sik Lee) 한국사회보장학회 1994 사회보장연구 Vol.10 No.2

N/A

건강보험의 이념과 의료정책

이규식 ( Kyu Sik Lee ) 한국보건행정학회 2018 보건행정학회지 Vol.28 No.3

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.

건강보험 40년 성과와 과제

이규식 ( Kyu Sik Lee ) 한국보건행정학회 2017 보건행정학회지 Vol.27 No.2

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.