Search

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 grants 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.

The objective of this paper is to investigate chronologically the life of Sigerist as follows: (i) how Henry Sigerist (1891-1957) became interested in medical history, (ii) how he succeeded Karl Sudhoff (1853-1938) as professor of the history of medicine in the University of Leipzig, (iii) why he came to the Johns Hopkins in 1932, (iv) what he did for health care reform in the U.S. and Canada, (v) why he returned to his motherland in 1947, and (vi) how health professions have been globally influenced by his life. Based on the solid academic scholarship of medical history and sociology, Sigerest was energetically engaged in health care reform. What distinguished his social activism from other health care reformers is that wheras most health care reformers take the positivism-centered perspective to transform the existing health care system, Sigerist integrated historical vision with sociologically a pedagogic mission to pursue health care progress.

A survey of canine heartworm (Dirofilaria immitis) infections among German shepherds in five areas of South Korea was performed from October 1994 to August 1995 using a microfilarial test (modified Knott's test) and an antigen test (DiroCHEK, Synbiotics, USA). The infection rate of 127 German shepherds (71 males and 56 females) was 10.2% (13/127) by the microfilarial test, but was 28.3% (36/127) by the antigen test, revealing that 24 of the 36 antigen-positive dogs were microfilaria negative in the peripheral blood. All dogs that were microfilaria-positive were also antigen positive. There of the microfilaria negative and antigen positive dogs contained 4.15 adult heartworms in the heart and pulmonary arteries upon necropsy. The infection rate among German shepherds was the highest in Hoengsong-gun (Kangwon-do, 84.4%), while those of Yechon gun (Kyongsangbuk-do) and Chungwon-gun (Chungchongbuk-do) areas were 20.0% and 14.3%, respectively. None of the dogs in the Kimhae-shi (Kyongsangnam-do) and Kwangju areas was heartworm positive. The infection rates of heartworm in dogs at the age of 1-3, 4-6, and 7-11 years were 6.2%, 21.4%, and 56.4%, respectively. Based on the fact that the antigen test is more accurate than the microfilarial test, this study strongly indicates that the prevalence rate of canine heartworm in Korea may be higher than previously reported (3.1 approximately 23.0%) which utilized microfilarial tests.

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.

From the perspective of research methodology, it may be said to exist two kinds of different historical approaches with regards to the formation of modern clinical medicine at the turn of the nineteenth century. One is to explain this in terms of the agency or structure that is associated with research topic. This historical view assumes that the Western scientific rationalism is characterized by the unity of Western tradition and its evolution as continuity. Its main focus is given either on how French revolution and war affected the growth of clinical medicine and the hospital reform movement or on how Paris Clinical School contributed to the birth of modern clinical medicine. The other is, according to Michel Foucault, to analyze how medical discourses are related to social (institutional) practices. Following Canguilhem's history of concepts, Foucault traces the historical development of the concept of disease. Elizabeth A Williams, another proponent of this method, conceptualizes the eighteenth-century medicine as three different medical discourses--anthropology, physiology and philosophical medicine, and analyzes how their structural fragmentation were transformed into the modern establishment of clinical medicine in the nineteenth century. ...

In his influential treatise System einer vollständigen medizinischen Polizey, Johann Peter Frank (1745-1821) made significant contributions to the establishment of the concept of medical police, which has been understood as the forerunner of social medicine. Cameralism, the German version of mercantilism, became the very basis on which Frank and other German writers developed the framework of medical police. 'Medical reform' was the catchword of German medical men in the 1840s. The medical reform movement of 1848 was partially caused by a deep political, economic, and social crisis. Although Industrial Revolution began in Germany later than in England and France during the first half of the nineteenth century, by 1848 the formation of German industrial working-class made medical reformers recognize the causal relationships between social and health problems. The outstanding figures in the German medical reform movement of this period were Rudolf Virchow (1821-1902), Solomon Neumann and Rudolf Leubuscher. In his famous Report on the Typhus Epidemic in Upper Silesia, Virchow proposed several radical measures that could be used against the epidemic: the absolute separation of the schools from the church, the establishment of self-government in the state and community, unlimited democracy, road building, and the improvement of agriculture and horticulture. ...