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2321 최호빈 Opposing the statement.
작성자 최호빈 등록일 21.05.20 조회수 55

 Since the term Tele-health system is new rising concept by the Wuhan virus crisis, we are not really comfortble with that. Unfortunately, what you stated is not significant.

  First, you mentioned there are five complicated medical care that cannot be done completely through remote health care (with Korean definitions. So sweet). You’ve stated that the tele-health system is only capable of asking and ocular inspection. And also, diagnosing depends on the image quality. This is not significant. Definitely. Since we are not used to the ‘real’ tele-health care system which is well organized, combined with newest techologies and innovation. Remote health care is somewhat highly banned in the Republic of Korea. According to Article 50 of the Pharmaceutical Affairs Act, pharmacy openers and drug sellers are not allowed to sell drugs at any place other than the pharmacy or store. Since we haven’t experienced well organized remote health care system, it might be hard for some people to imagine one with more capabilities. Let us take the example of China, the country accepted tele-health system way earlier than the Republic of Korea. In 2018, a company called Ping Anhaoyi Province operates an unmanned clinic. This clinic consists of medical artificial intelligence and drug vending machines. In the three-square-meter examination room, patients can be diagnosed by artificial intelligence, and medications can be prescribed immediately, and medications that are not in the vending machine can be shipped home. In this vending machine’s small room, patients can be diagnosed by the facilities in there. Simply saying, at least, asking a patient about his condition, and ocular inspection, and auscultaion is possible by doc far away or innate A.I. What you stated, ‘only asking an ocular inspetion are available’ is not necessary. First, it is helpful for some people in remote areas compared to nothing. Second, well organized tele-health system is can’t be compared with ancient, uncivilized, gigabot stuffs. Third, artificial intellligence and facilities supports this remote health care system. And there are more possibilites of development. The five steps for medical care are truly important but that cannot be the reason for banning tele-health system. Since there is no large hospital in Ulleung burough and the distance from the land is highly considerable, tele-health system is being performed. According to United News, Keimyung University Dongsan Hospital is in charge of the health and well-being of Ulleung Island residents through the tele-health care system. So imagine if you are a doc. Will you abandon tele-health sysem that can save people living in rural, remote areas just because you cannot follow the five steps? At least, make tele-health system legal and use it as a source of redeem sounds more right.

 Second, you mentioned that ‘Korea has excellent access to medical institutions. So it can further accelerate the phenomenon of leaning toward large or near Seoul hospitals.’ Seriously? Excellent access you think? Let us look at the article by the Korea Institute for Health and Social Affairs. ‘Emergency medical care is an important social safety device that guarantees the people's right to live.The life of an emergency patient is fatal if treatment is delayed because there is a golden time to receive appropriate treatment for each disease. Need However, when looking at the actual state of emergency medical resources in Korea, there is an absolute shortage and imbalance between regions. Our country, considering the increase in emergency patients, the supply base for emergency medical care is somewhat insufficient. The number of patients admitted to the emergency room increased by 10.0% from 8,099 thousand in 2006 to 8,906 thousand in 2008, while the number of treatment beds at emergency medical institutions increased by 8.0% from 6,466 in 2006 to 6,982 in 2008, showing a somewhat insufficient pattern. Also, since most emergency medical care in Korea is dependent on the private sector, the reality is that the imbalance is severe. In 2004, the nation was divided into 50 emergency medical treatment areas, and as a result of analyzing the supply compared to the demand of regional emergency medical centers, it was found that there were 14 oversupply, 16 adequate supplies, and 20 undersupply. More seriously, it was found that out of 20 treatment zones where the number of regional emergency medical centers was insufficient, 16 treatment zones had no regional emergency medical centers at all. Most of these areas were rural areas. In other words, if a severe emergency patient occurs among residents in these short supply areas, the likelihood of dying is higher than that of other residents. On the other hand, in the case of excessive treatment rights, the proportion of mild emergency patients who do not necessarily use local emergency medical centers increases, which wastes emergency medical resources and increases inadequate medical expenses.‘ Additionally, the airbourne transport of patients rely heavily on 119. Morevoer, the rate of first aid treatment on site and during transport was 36.8% in the 2004 survey. In particular, advanced first aid measures such as intratracheal intubation, securing veins, and the use of automatic defibrillators, which are necessary for severe patients, are rarely performed. South Korean access to medical instituion is not perfect at all. (You then stated that it can further accelerate the phenomeon of leaning toward large or near Seoul hospitals. I don’t get what you intend to say. Does concentration of institution in certain area sounds good to you?) 

Third, you argued that there can be trouble with accurate diagnosing, since the work of health care is complicated. I agree with what you wrote, this time. When Korea accepted the tele-health system, it will lower the level of trust and cause many side-effects. Even though considering all new start cause some harm, the outcome will be disastrous. At least, I would like to mention tele-health care system is developting, although still need more inputs and efforts.

  I think the fourth one is somewhat similar to the first one, so I would like to ask you to excuse me for skipping this one.

  Fifth, you mentioned that since medical service doesn’t require much staff except doctors, so jobs related to health care will be reduced. It is a little bit disappointing that there is no any specific example for the word ‘health care workers’. What you wrote is not significant. First, is it bad for health care servicers to leave the frontline and be replaced by new system? We have faced the new era ruled by highly infectious Virus. Numerous nurses and workers bleed for our health care. It is bad for relieving their burden by tele-health system? Secondly, will the jobs related to health care business just disappear into air? According to Daewoong Pharmaceutical, the telemedicine service market has grown further as wearable monitoring devices and digitized medical images have been developed with the development of communication and medical technology. According to market research firm IBIS World, the U.S. telemedicine service market has experienced an explosive growth rate of 34.7% per annum over the past five years, reaching $2.4 billion in 2019. Telemedicine in China began in earnest in 2009 when the State Council announced an opinion on reform of the medical health system in order to improve the lagging medical system. Since then, the introduction of telemedicine has been promoted as a core project of medical reform under the full policy support of the Chinese government. By allowing remote medical care between doctors and patients, we are expanding remote medical services such as remote consultation, remote monitoring, and issuing electronic prescriptions, and greatly easing regulations related to remote medical care. As a result, the telemedicine market in China is growing rapidly, and in 2016, the telemedicine service market in China reached 6.15 billion yuan. As the market is growing as countries around the world are easing regulations on telemedicine, it is expected that the market ripple effect will be great if Korea is also easing regulations. Fighting Research Institute analyzed that if telemedicine is allowed between medical personnel and patients, which are prohibited under the current medical law, 5.46% reduction in remote medical expenses 6.7% increase in remote medical service supply 5.16% increase in remote medical-related jobs. In addition, the growth of the domestic telemedicine market is expected to have an effect on the overall economy of the Republic of Korea, such as an increase in annual GDP of 2.4 trillion won an increase in total consumption of 5.9 trillion won an increase in 2000 jobs. As a summary, the number of jobs related to health care system and the economy is boosting in other countries.

Concluding your arguments, you wrote accepting tele-medicine is not possible unless after having a national solution of the above five (four actually) problems and improving citizen’s awareness. To criticize this a little bit, is there are specific example to prove citizen’s awareness of tele-medicine? And blaming citizen’s awareness suddenly seems awkward. Why should citizen’s awareness should be blamed by medical systems pros and cons?

  To wrap up, the arguments you wrote are somewhat right in some aspects, but are not significant. We should not be afraid of the change, Every successful innovation starts with a challenge. For better Korean health care, teh tele-health care system must not be banned.

 


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