한국보건사회연구원

인구구조 변화와 그에 따른 파급효과는 사회 전 분야에서 광범위하게 나타나며, 이를 해소하기 위한 정부의 정책적 대응 역시 다양한 차원에서 이루어진 바 있다. 우리 원은 국민의 삶의 본질과 정부 정책 대응간 유기적 연결을 강화하고자, 인구포럼을 기획하여 올해로 7년째 운영하고 있다.

2020년도 인구포럼은 우리사회가 당면한 현실에 보다 가까이 다가가고자 노력하였다. 이에 제1차 인구포럼에서는 ‘젠더관점에서 저출산 대응을 위한 사회구조 분석’을 주제로, 제2차 인구포럼에서는 ‘세대 공감’을 주제로, 제3차 인구포럼에서는 ‘감염병 확산에 따른 국내외 노인 돌봄 환경 변화와 대응방안’을 주제로 진행하였다.

본 보고서에서는 세 차례의 인구포럼을 통해 발표된 발표문과 토론자들의 토론 내용을 담고 있다. 이같은 논의가 인구문제와 관련한 정부 정책, 사회 대응에 대한 대국민 접점의 기제로써 적극적으로 활용되기를 희망한다.

In the global pharmaceutical market, new drug R&D never stops. Technological innovations have made it possible to design treatments for what have been regarded as severe and intractable diseases, and groundbreaking drugs with the capability to provide fundamental cures continue to enter the market. These inventions not only expand the scope of available treatments, but also demand fundamental changes in regulations, medical cost calculations, and health systems, at an increasingly accelerated pace.
The fiscal sustainability of health systems is a pressing issue faced by each and every nation today, and accountability is required of all stakeholders to ensure it. New drugs carry great uncertainty in terms of clinical effectiveness, fiscal impact, and cost-effectiveness. Risk Sharing Agreements on these drugs attest to the importance of sharing fiscal risks. As risks are determined and shared in relation to the aggregate health expenditure, payers and the industry alike, as well as the medical community and the public, should participate and share risks. It is high time for us to start serious discussions on how to ensure that all participants are held accountable for their behavior and decision-making, particularly by enforcing the self-regulation of medical practitioners, reforming the National Health Insurance payment system, and making coverage and its continuation dependent on technology evaluation.

Over 13,000 people end their lives by suicide each year in Korea, ranking the country at the top of the Organisation of Economic Cooperation and Development (OECD) rankings of suicide rates. The central focus of this study is the first stage of suicide prevention policy―namely, the stage in which who should be targeted by the policy is decided and how groups at high risk of suicide are to be identified.
Ascertaining the demand for policy support and whom the policy should benefit and deciding the policy tasks accordingly should be prioritized before establishing a policy plan. Also, it is crucial to continue conducting research on people at high risk of suicide and develop a more evidence-based approach to suicide prevention. Finally, the individuals and groups that make up a given society all bear the duty to help realize a safe and reassuring environment and form mutually supportive relationships with friends, families, and neighbors.

The purpose of this study is to establish a convergence and linkage system that can bridge the gap between health welfare policy and technology, assuming that new technology is a means to increase the effectiveness and efficiency of health welfare policy. Big data analysis is used as a basis for establishing evidence-based policies in the process of establishing health and welfare policies, and new technologies such as artificial intelligence (AI) can greatly increase their utility value when combined with big data.
This study is a mid-term task for three years. In this year, the first year, we will derive welfare demands that people can feel based on big data and present the current state and direction of new technology application.

Care services provided by local public schools are designed to look after children while their parents are away at work, but the rigid eligibility criteria and sheer shortages of available services leave many children vulnerable to the lack of care. Our survey reveals that 30.7 percent of respondents struggle with the lack of afternoon care during the week. That figure rises to 39.7 percent among respondents from households with both parents working. The existing childcare service structure is limited in a number of ways to provide effective and adequate childcare in response to the demand. Childcare policy for schoolchildren ought to strive to provide universal care so as to protect and uphold children’s right to care. Therefore, limits on eligibility should be removed to greatest extent possible, and the number, scope, and diversity of available services should be maximized.

The purpose of this study is to gather and present empirical data on Koreans’ happiness and quality of life so as to help researchers find a theoretical model of Koreans’ happiness and aid policy makers in developing specific policy solutions toward improving Koreans’ quality of life.
Survey on Koreans’ Happiness and Quality of Life 2019 was conducted to gauge Koreans’ subjective well-being. This paper analyzes and presents Koreans' perception of happiness and Koreans' happiness map using the survey data.

Motivated by the need to decide the direction of a user-centered policy support system for young adults, this study takes a life course perspective on the spatiotemporal contexts of young Korean adults’ lives and how their life experiences have shaped their present, exploring the experiences of disadvantages they have faced and/or continue to face. To that end, this study combines both qualitative and quantitative methods. The results of our quantitative analysis highlight the need for a multidimensional approach to policy support for young adults. Also, our qualitative analysis provides a detailed understanding of the life course of disadvantaged young adults. Young adults’ current life is a result of the interaction among various factors in the specific time and space they have lived. The different ways in which these interactions have panned out and individual choices had significant effects on the lives of young adults who seemingly started out from similar places.
Based on our analysis, we propose: (1) redefining the roles of the social policy system and enhancing its accountability for young adults, (2) introducing more specific and refined measures of policy support that reflect the diversity of young adults’ situations and needs, (3) revisiting the security and consistency of young adult policy support and the social security system at large, and (4) developing a realistic index of social security for young adults and applying it to policy monitoring.

There are diverse paths to reducing income inequality. The most intuitive is to increase the income of the poor. Another is to reduce the burden of household expenditure on essential goods and services, particularly for the poor. Filling up a tank requires not only pouring more water into it, but also blocking the holes at the tank’s bottom. The latter approach is the subject of this paper. Reducing the financial burden of essential household expenditure on low-income families is as important a matter of policymaking as increasing household income. Of particular interest to this report are the amounts of money that Korean households spend on housing, healthcare, and education, as well as debts. This report compares Koreans’ spending on the categories to those of Americans, Germans, Swedes and Japanese, respectively.

Whereas youth who age out from out-of-home care systems undergo a lot of difficulties economically, psychologically, and socially, the difficulties are preventable when the youth are well-prepared for independent living. However, there has been little study that examined how much youth in out-of-home care are prepared for independent living and how out-of- home care systems help them live independently. Therefore, the purpose of this study is to investigate out-of-home care youth’s readiness for independence, experiences with receiving support and resources for independence, and demand for support for independent living.
The study results reveals that there are significant differences in youth’s readiness for independence and experiences with independent living support and resources across types of out-of-home care: institutional care, group home, and foster care. Based on the study findings, this study has made some suggestions to improve independent living support system and the quality of independent living services.

This study aims to empirically determine the fiscal capability of the South Korean welfare state to withstand the inevitable increase in welfare spending that would be incurred as part of the cost of unification with North Korea. We explicitly assess and compare South Korea’s fiscal sustainability both under integration with North Korea and the absence of integration, with the likely changes in the demographic structure and unemployment rates. It then examines how South Korea’s fiscal sustainability would be affected under the worst imaginable macroeconomic circumstances that could arise after inter-Korean integration.
The analysis reveals that the South Korean welfare state is fiscally robust. Insofar as the Korean government maintains its current fiscal stance (effective as of 2015), it would most likely ensure the fiscal sustainability of its welfare programs. Even when North Korea’s demographic structure and labor market situation are taken into account, South Korea could manage its fiscal sustainability competently. In such an extreme case, where the country’s national debt level is double the 2015 level, and the country faces a sudden economic crisis like the Asian Financial Crisis of the 1990s, its fiscal sustainability could be compromised. In reality, however, the chances of such an abrupt and unforeseen deterioration in a country’s economic status are slim. Therefore, we should take caution not to exaggerate the likelihood of such scenarios, even as we prepare for the possible risks of the worst-case fiscal scenario. The best way to reduce uncertainty as much as possible is to establish and strengthen mutually beneficial relations between the two Koreas.