Institute of Health Policy and Management, Medical Reseach Center, Seoul National University, Seoul, South Korea.
Int J Health Serv. 2011;41(2):371-88. doi: 10.2190/HS.41.2.j.
After the 1997 economic crisis, the South Korean government implemented neoliberal policies in many sectors. In health care, the government attempted to privatize nine public hospitals, framing the initiative as "better management." In this discourse, public hospital workers were stereotyped as lazy and incompetent, while public hospitals were portrayed as poorly managed and of low quality. However, the government did not present any relevant evidence of improvement in already privatized hospitals, even though three hospitals had been semi-privatized at that time. In this study, the authors evaluated the effects of the semi-privatization, comparing the performance of the semi-privatized hospitals with that of the nine other hospitals targeted for privatization. The study found adverse effects on performance, unlike the claims made by the government. Semi-privatization intensified the workloads of hospital workers and the instability of employment, froze or decreased real wages, and drastically increased hospital revenue per patient stay. The changes may have resulted from redefining profit as the goal of the hospitals, as opposed to the previous focus on decision-making on public health. These research findings played a decisive role in the struggle to keep the targeted public hospitals free of privatization, especially in two of the nine hospitals targeted for privatization in 2001.
1997 年经济危机后，韩国政府在许多领域实施了新自由主义政策。在医疗保健领域，政府试图将 9 家公立医院私有化，称此举是为了“更好的管理”。在这种论调中，公立医院的工作人员被刻板地描述为懒惰和无能，而公立医院则被描绘为管理不善、质量低下。然而，政府并没有提供任何已经私有化的医院有所改善的相关证据，尽管当时已有三家医院已经半私有化。在这项研究中，作者评估了半私有化的效果，将半私有化医院的绩效与另外 9 家拟私有化的医院进行了比较。研究发现，与政府的说法相反，半私有化对绩效产生了不利影响。半私有化加剧了医院工作人员的工作量和就业不稳定，冻结或降低了实际工资，并大幅增加了每位住院患者的医院收入。这些变化可能是由于将利润重新定义为医院的目标，而不是之前关注公共卫生决策所致。这些研究结果在反对将目标公立医院私有化的斗争中发挥了决定性作用，尤其是在 2001 年拟私有化的 9 家医院中的两家。
