뉴스풀이2013. 10. 7. 15:17

파괴적 혁신이론으로 유명한 클레이튼 크레이텐센 교수의 컨설팅업계에도 파괴적 혁신이 진행되고 있다고 주장이 실린 기사입니다.  좀 긴데요^^ 차라리 홈페이지에 링크된 팟캐스트를 듣는게 좋을 것 같습니다.  느려서 듣기 편하네요.

작은 기업 컨설팅 시장에서 파괴적 혁신은 시작된 것일까요?


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Clay Christensen and Dominic Barton on Consulting’s Disruption


AMY BERNSTEIN: Welcome to the HBR IdeaCast from Harvard Business Review. I’m Amy Bernstein, and I’m here today with Clayton Christensen, professor of Business Administration at Harvard Business School, and co-author of Consultants on the Cusp of Disruption, a feature in the October issue of HBR. Joining us on the phone is Dominic Barton, Global Managing Director of McKinsey and Company. Dom, Clay, thanks for being here today.

CLAYTON CHRISTENSEN: Delighted to be with you

DOMINIC BARTON: Great to be here.

AMY BERNSTEIN: Clay, you’ve documented the phenomenon of disruption for years across numerous industries, probably most famously in the steel business. What are you seeing in the world of general management consulting?

CLAYTON CHRISTENSEN: Well, I will say that I see disruption occurring there, but everybody needs to know that we’re not pointing the finger at everyone else, that the process of disruption is occurring against the Harvard Business School itself. So this is not just a targeted shot at any one. But you do see it happen, and disruption always occurs in ways that it emerges in parts of the market where you wouldn’t even think to ask.

And in this case, what disrupts any business is somebody takes a piece of business that is not attractive to the leaders, and because it’s not attractive in the pursuit of profit, they go to bigger and bigger, and nicer and nicer pieces of business. And then the disruptor starts at the bottom and moves up. And what’s attractive in the consulting business is big clients who have big problems. And the more they can have more of those kinds of clients, the more profitable they become.

And what they leave behind are small pieces of business– small companies; tangible, immediate projects that they do and then you leave. And those are the kinds of disruptive innovators in consulting that are taking root. And then they move up, going after bigger and bigger pieces of business.

AMY BERNSTEIN: Does this differ in any way from what you saw in manufacturing, and what you see in other industries?

CLAYTON CHRISTENSEN: Yeah. Really, disruption is a process. The theory itself is in evolution over time. So at the beginning, we thought that the vertical axis in the disruptive diagram was the quality of the product.

And then we realized that, no, that’s just what customers are more profitable versus less profitable. And when we understood that, just everything fell into place. So for example, if you think of the airline industry as being disrupted, what’s the vertical axis on that diagram? I mean, once you have economy and first class, how do you go up market from first class? It just doesn’t make sense.

But then we realized, oh my gosh, it’s the length of the route. Long routes are more profitable than short roots. And so the big majors are getting out of short routes, and turning that over to regional jet providers so that they can go into longer and longer international routes where the margins are. And once you understood that, it’s happening.

AMY BERNSTEIN: So that’s your point about bigger problems, bigger clients? That’s the top of the y-axis?

CLAYTON CHRISTENSEN: That’s exactly right.

AMY BERNSTEIN: Dom, when did you know the world of consulting was changing, and that McKinsey had to change, as well?

DOMINIC BARTON: Well, first of all, I think I’d say that the consulting has been changing. For the last, I think, 20 or so years, there have been changes. And I think what was, if you will, an inflection point was– for me, at least– was in 2009, when I took on this role, I had some work done, which we recommend. We typically have our clients do when a new CEO comes in– which was just, how’s the global context shifting? And it was a work called global forces, which are, what are some of the core shifts over the next 15 to 20 years as far as we can see out, recognizing that could be a difficult thing to do?

And to cut a long story short, that work kind of said to me that we are in a time for some significant change in the world, and why should we think that we’re immune to that? I try to see– Amy, as you know– two CEOs a day, and one of the things that always came through was technology’s moving five times faster than management. I don’t know whether to be paranoid or excited. I’m typically both, with sort of a comment– this shift towards Asia and Africa, resource scarcity. Just a lot of big issues, and it just made me think, well, maybe we better think about what is that we’re doing.

And so as a result of that, we’ve launched a kind of an internal strategy review, which basically was an 18 month process, again, where we took our own medicine, and spent a lot of time talking with our clients, and also with people we don’t work with– clients we would like to serve, but companies that we’ve never served, talking to people outside the industry, observers and so forth. And it suggested that, as Clay has written in the article, that change is afoot in many dimensions.

AMY BERNSTEIN: Can you talk a little bit about what you were hearing specifically from CEOs that made you think you needed to go back and challenge the orthodoxies of McKenzie?

DOMINIC BARTON: Yes, there were a number of things. I think one was, why does every issue or opportunity or problem take a project manager plus two associates three months to solve it? Surely, there are other ways, more efficient ways. Surely, sometimes we may just want data. If you guys had collected information on how hospitals work, and you had a large number of them, and looked at how often an operating table was used and so forth, and collected data like that, we may just want the data, not the people, if you will.

So there was a notion of be more flexible. What we really value is x versus y. Sometimes, you go into far too much analytical detail. We only need to go 60% of the way to be able to get it.

We value the judgment, not so much the analytics. And this obviously varied by situation and type of client. But there were a lot of questions on– or suggestions on– you could be a lot more flexible in terms of how you work with us– the type of people, the amount of time, and so forth.

AMY BERNSTEIN: Anything about this strike you, Clay?

CLAYTON CHRISTENSEN: Actually, no. McKinsey is doing all of the right things. And yet, by doing the right things, it sets in place the process of disruption, which you then have to account for. And so the descriptions of the work that they’re doing– unbelievably foresighted work about complicated problems– is what we would call sustaining innovations. It’s hard to do, and that’s why they do it so well.

And then, when they take low-value adding activity, and outsource that to somebody, if you listen to the people in that company about what do they do next and next and next, they will try to do more and more high-value adding work relative to where they started out. And so the process is– he’s described it exactly right. And dealing with that is the big innovator’s dilemma.

AMY BERNSTEIN: So Dom, talk a little bit about McKinsey Solutions, if you would, if you could describe it. And tell us about the internal re-think that led to it.

DOMINIC BARTON: Sure. Well, as I mentioned, we did this– we called it a firm strategy review, which isn’t a very exciting name, but that was the 2010 effort we launched where, again, we talked to a whole range of clients and non-clients and third parties, if you will, and also alumni; and in that, a number of ideas for how we could work differently with clients, and what we work on or put forward. And one of them was actually an idea that had already been lurking in the background. It had come in in 2007, which was around taking data, if you will. And we sort of stumbled into it, and I’ll give an example.

One was around Chinese consumer insights. We found– when I was living in China, we couldn’t rely on a lot of the publicly available data, and what consumers were doing. So it just wasn’t reliable or it wasn’t accurate, so we started to develop our own. And we built a very large database of the Chinese consumer– the middle class consumer who’s changing at a very rapid rate, far more rapidly than we’ve ever seen before.

And I won’t bore you with all the detail of it, but we built that. And then what we found was that that database was something that actually clients wanted, and they wanted that– was the prime thing they wanted, as opposed to the McKinsey people around it, if you know what I mean. They said, we would actually like that data, and you’ve been collecting it, and we’ll pay for that. We don’t really need a team.

And so, that was one of the early McKinsey Solutions. There were some things in health care and a number of other areas. And we were experimenting with this, but the firm strategy review really kind of popped that out. And people said, boy, if you had that type of thing, we’d be very interested in that sort of information, and a new way of working with people, and so forth.

So that was the genesis of it. There had kind of been glimpses of it, or it was lurking in the organization. We weren’t really aware of what we had. It was brought more to life through this review.

And then, what I did on that one was put one of the most experienced senior people in the firm– actually, Michael Patsalos-Fox, who is a very close friend, and has been in the firm for 30 years. He used to run our Americas group. I had him lead our McKinsey Solutions.

And it was a bit of New Ventures Group, but McKinsey Solutions was a big part of it, because I knew he would stimulate it and he’d protect it, because one of the things– I’d be interested in Clay’s view– but when you try new things, it’s amazing the number of people and antibodies that are in the organization that try and kill it, because it’s different, and it’s why are we doing this? And we’re cannibalizing something, this isn’t right– all that sort of stuff.

So we needed a very strong leader to protect it, if you will, and nourish it. And he did. And he took that from kind of having– I guess there were three of them, to I think we now have 18. And it really was to help develop the model.

By the way, some of them have not worked. We’ve had to shut them down. But fortunately, the vast number of them are working, but it meant we had to change our people processes, right? A person who is running a McKinsey solution, which is more like a piece of software. So that’s sort of a bit of an overview.

AMY BERNSTEIN: It’s really interesting. And Clay’s been taking notes. I wonder what you think of what Dom’s been describing.

CLAYTON CHRISTENSEN: So you’re doing everything right that I can imagine you would do. And as a result of that, I worry about you. My wife said that she describes me as the Jewish mother of business, in that it doesn’t matter everything that is going right, a Jewish mother always worries about what’s not going right.

So just by analogy, disruption occurred in the traditional department store business. In the early ’60s, there were over 300 department stores. There are now only eight remaining. Macy’s is the largest.

And they were disrupted by discount retailers like Walmart and Target and Kmart. And the way the traditional department stores made their money is they generated gross margins of 40%. They turned their inventory over three times a year. So they got 40% times 3 equals 120% return on capital invested in inventory every year. And that’s the way they measured things.

When the disruptive retailers came in, they generated gross margins of 20%, and they turned their inventory over 6 times a year. So 20% times 6 equals 120% return on capital invested in inventory. And so their profitability– the bottom line was the same, but the method by which they generated that result was different. And that was the killer.

And so, the challenge– which will be a perpetual challenge– is that imagine that McKinsey Solutions in fact becomes very profitable. And its bottom line is the same. The formula by which they generate the profitability will be different.

And so every day, somebody’s going to come in to senior management saying, that doesn’t make sense, because from their perspective, it doesn’t make sense. And I wish I could say from my studies that that will go away, but it’s just smart people in the core business trying to improve their profitability when they see resources being spent on something that, from their perspective, doesn’t make sense in their belief that they’re helping McKinsey [? treasury ?] to stop doing what disruption says you should do. And so it’s a long way of saying congratulations, and oh my gosh, be careful.

DOMINIC BARTON: I think that’s very good caution.

AMY BERNSTEIN: So Dom, how do you deal with those antibodies, the ones that you referred to, that Clay just described?

CLAYTON CHRISTENSEN: And they’re not bad antibodies.

DOMINIC BARTON: No.

CLAYTON CHRISTENSEN: Isn’t it they exist in the pursuit of profitability, but they’re antibodies nonetheless.

DOMINIC BARTON: Yeah. And also, I think it’s the– we don’t measure profitability like a department store in that sense where I know where it is. But it’s also tradition, right? It’s kind of we’re here to work in a particular way. We’re not a software house. I mean what is this? There’s that element that comes in, too.

One of the things I found, by the way, is history is just a good thing to look at in your own institution as to what’s worked and what hasn’t worked. And so one, believe it or not– this sounds very trite– was when we decided to move to Europe from the US in 1959. There was a huge debate about it. I think the partnership with split as to whether this was a good idea or not to do it.

Another incident that I looked at was when we established the Global Institute, right? This was a research body that was actually set up purposely to do nothing to do with client work, if you will. It was a micro view of macro issues so as to help advance the state of management. But it explicitly could have not a direct link to clients.

And I thank God every day that we’ve got that Institute up and running, but I know that there were so many people that tried to kill that thing for probably 8, 9 years in McKinsey. We’re not a think tank. Why are we wasting this money? How much are we paying these people? Blah, blah, blah.

So in a minor way, I’m fearful of the antibodies, because I’ve seen them, and I know that just from some of the things we did do, it took extraordinary leadership of some of the people in those places to kind of– they’ve probably got a lot of scars on their back to keep it going. So I think also relating that a bit to the organization is important, to say, you know, we actually have done some things differently.

One other story. I remember when we set up our operations practice. And I sometimes tease people about this in McKinsey. It was in, like, 1990, I think, is when that started. And this is how to do lean, and how to take costs out of procurement and so forth.

And there was quite a raging debate in McKinsey about going into this. And this isn’t, again, so much an innovation in how we work, but certainly wasn’t what we work, because we were seen as a strategy firm. And there were literally comments from some senior people in McKinsey, saying, we don’t want to do that type of work. That’s the work that knuckle-draggers do. I mean, really sort of rude statements were made to this group of partners that wanted to build this practice.

And again, I think there were some lessons learned from us, and why that practice was able to grow and be successful, even though they did things in quite different ways. We hired quite different people because of how they worked with the organization, what they stood for, how committed they were, all this sort of stuff. So those are things that are going on.

But I’m trying desperately to look as much as we can for wherever we’ve had some innovation, to try and drive it, and then kind of relate that to people and say, you know what, guys, I know this may seem strange to you in where it is, but we have done this. My only worry is I think that the speed and pace of change that we’re going to have to go through is going to go faster, and be bigger given these global forces. And that’s where I think Clay’s Jewish mother analogy is a good one. A bit paranoid about that.

CLAYTON CHRISTENSEN: Good for you. It is so exciting for me that I can’t stop jumping up and down here.

DOMINIC BARTON: One other thing, Amy. I was going to ask Clay this. To what extent do you think it’s normal– I’m struck by that some of the changes that you need to go through are actually lying around in the organization, but we don’t recognize them. So sometimes I wonder, maybe we don’t know what we have, if you know what I mean, that could help us.

CLAYTON CHRISTENSEN: It’s a great observation. And what you can predict is that all of these things are bubbling up, and the organization itself will only identify those things that help the organization make more money in the way it’s structured to make money. And if there’s an idea that is proven at a small level, if it doesn’t fit the way the organization makes its money, it will either languish, or the organization will force it to conform itself to the way it makes money.

And so you have kind of two strikes against it in that it won’t come up to the top as an interesting idea if the organization can’t use it. And then b, even if they see it, they will make it conform itself to the way they make money. And to have something that truly is disruptive– and in this case, that deep understanding of how an area or an industry works– and use that in the context of McKinsey Solutions, which would be a disruption in disruption, is really hard to do. And if you could pull it off, my gosh, congratulations It just is really hard.

AMY BERNSTEIN: So this last question is to both of you. Where is the consulting industry going? What’s it going to look like in the next 10 to 20 years?

CLAYTON CHRISTENSEN: So I would bet that the existing leaders are going to be very vibrant 20 from now. And what they’re going to be increasingly known for and good at are the complicated problems for which there is no standard solution, and that there are projects that they can bill at higher prices for the world’s largest corporations.

AMY BERNSTEIN: So scale is an important factor in this complexity?

CLAYTON CHRISTENSEN: That’s right. That’s right. But on the other hand, there will be new companies that begin to be more and more important. And things that today seem out of the ordinary, unique, judgment-filled, a generation from now these will be standardized and outsource-able.

And it’s those that hit the outsourcing balls from McKinsey. They then start doing the low-value adding stuff. And then always the next question is– next year, how can we provide more and more value adding? And so, my bet is that 20 years from now, there will be people who today aren’t significant now start to become more and more significant.

And I think we can predict that. And it’s not because I wouldn’t ever attribute anything to McKinsey doing anything wrong. It’s doing things right that makes it hard.

AMY BERNSTEIN: So from where you sit, Dom, does that seem to be where the industry is going?

DOMINIC BARTON: Yeah, I think I would agree with Clay in the sense that I think there will be some new players. I’m biased. I’m determined that we’re going to be around and be leaders come hell or high water. But I think the way what we do and how we work will, I think, have changed pretty significantly.

And what I mean by that is if I– again, I go back to the kind of 70% of our work was in strategy, organization. Corporate finance is now 30%. I think we’re going to see at minimum that kind of a shift in terms of what we’re working on, but more importantly– as Clay said– is how we’re working on it.

And I think there will be any elements that can be disaggregated or outsourced will be out. And just to put a personal example on it, I remember one of the very first projects I did in McKinsey. This was in 1986, was a consumer goods project we were trying to figure out.

It was for a fast food company, and what the size of a particular meal should be– how many pieces of chicken should be in the order, and so forth. And I think it took six months to come up with a recommendation. I think with today’s technology– the search technology, the amount of data that’s available– I’d be surprised if that project wouldn’t take two weeks, if you will.

CLAYTON CHRISTENSEN: Absolutely.

DOMINIC BARTON: And the last thing that sort of goes through my mind is the work that Foster did on looking at the average lifetime of an S&P 500 company. And that one, if I had anything that’s over my office wall, that’s one– you know the average. I think the average lifetime was something like 90 years in the mid 1930s, and now it’s somewhere in the order of 18 years. And so I just think we have to have an assumption, a bit of a paranoid view of where we have no God given right to be here, so we better be spending some certain amount of resources or experiments going on.

CLAYTON CHRISTENSEN: Amy, can I just add one other thing?

AMY BERNSTEIN: Of course.

CLAYTON CHRISTENSEN: I think in many ways, the business of the Harvard Business School is to develop useful theories about management that can be used. And in many ways, McKinsey and its competitors in the consulting business are a distribution channel for our ideas. And if they aren’t vibrant, then we don’t have a way of getting our ideas to individual– individual people can read the Harvard Business Review. But for an idea to impact a company, we don’t have in academia a channel for that idea. It has to be people like McKinsey, who– I’m sure that you won’t be happy with my referring to you as a value adding reseller.

DOMINIC BARTON: No.

CLAYTON CHRISTENSEN: You take an idea, you value add it, and you send it. And it’s just very important to us that we have a great relationship with you. And if I were going to be a Jewish mother for the Harvard Business School, I would say, ladies and gentleman, have you noticed that McKinsey is pulling in-house the development of the next generation business ideas?

And when you see that happening, as the provider of the ideas, we got to say, we need to just look at the mirror in a very, very thoughtful way.

AMY BERNSTEIN: Well, thank you both. That was Harvard Business School professor Clayton Christensen and McKinsey Global Managing Director Dominick Barton. For more on this, go to hbr.org.

Posted by JsPark21
뉴스풀이2013. 9. 7. 10:28


우리들병원, ‘의료관광 세계 10대 병원’ 재선정

7년간 전 세계 88개국 7,141명 유치---미 의료관광평가협 선정


우리들 병원이 미국 의료관광평가협의회에서 주관하는 세계 의료관광병원 랭킹 순위 10위권에 들었다고 하네요, 멋진 일입니다.  하지만 미국의료관관평가협의회가 얼마나 공신력이 있는 기관인지는 기사에 나오지 않았군요...2009년에 세워진 단체라고만...  나머지 9대 병원들의 리스트를 얻었다는 게 더 중요해 보입니다.



*10대병원 리스트*


우리들병원

프린스 코트 메디컬 센터(Prince Court Medical Center) 

독일의 아스클레피오스 클리닉 밤베크(Asklepios Klinik Barmbek)

레바논의 클레망소 메디컬 센터(Clemenceau Medical Center)

인도의 포티스 병원 방갈로르(Fortis Hospital Bangalore)

태국의 범룽랏 병원(Bumrungrad International)

방콕 병원 메디컬 센터(Bangkok Hospital Medical Center

터키의 아나돌루 메디컬 센터(Anadolu Medical Center)

싱가포르의 글렌이글스 병원(Gleneagles Hospital)

인도의 아시아 심장 기관(Asian Heart Institute) 



Posted by JsPark21
뉴스풀이2013. 8. 27. 10:30

현 시점에서 아시아에 97년과 같은 위기가 올 지도 모른다는 우려가 확산되고 있습니다.  하지만 기사에서는 그 정도는 아니며 곧 아시아시장은 회복될 것이라고 얘기하고 있네요.  근거가 조목조목 타당합니다.^^ 97녀에 호되게 당하고 나름 준비해왔다고 합니다. 투자 시 참고하세요.  이번에 터질 곳은 아시아가 아니라...다른 지역일 수는 있겠죠.


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http://news.heraldcorp.com/view.php?ud=20130826000160&md=20130827003516_AT



버냉키 쇼크 신흥국 위기 1997년과 같은점과 다른점


1997년 아시아를 뒤흔든 외환위기 망령이 되살아나고 있다. 

‘외국인 자본이탈→주식시장 폭락→통화가치 급락→외환보유액 급감ㆍ금리급등→외환위기’라는 이른바 주가ㆍ통화ㆍ채권이 동시에 하락하는 ‘트리플 약세’ 공식이 16년이 지난 현재 다시 재연되고 있는 것이다. 여기에 경기둔화로 인한 수출 감소와 경상수지 악화도 닮은꼴로 지적되고 있다. 

하지만 무함마드 엘 에리언 핌코 최고경영자(CEO)는 “신흥시장이 불안한 모습을 보이고는 있지만 1990년대에 비해 체질이 탄탄해졌기 때문에 그때 같은 붕괴 위험은 없다”고 역설했다. 엘 에리언은 신흥국에서 “매우 탄탄한 외환보유액이 완충 역할을 하고 있고, (1990년대에 비해) 정책 신뢰도가 높으며 환율도 유연하다”고 지적했다. 이어 “모두가 다 그런 건 아니지만 대부분은 1990년대에 비해 스스로에 훨씬 더 높은 보험을 들어둔 상태”라고 덧붙였다. 

또 1997년 IMF에서 아시아 지역을 담당했던 스티븐 슈바르츠 BBVA 아시아 부문 수석 이코노미스트는 월스트리트저널(WSJ)에 “만약 아시아 금융위기를 10 정도로 본다면 현재 상황은 3 수준”이라면서 “이번 사태는 단기적인 현상이며, 조만간 지나갈 것으로 본다”고 평가했다.

▶이것이 똑같다=최근 신흥국 상황은 선진국의 통화정책이 긴축으로 돌아서면서 대규모 자금이 이탈하고, 경상수지가 악화하며 단기 외채가 증가하고 있다는 점이 1990년대 상황과 유사성을 보이고 있다. 

1990년대 자본 자유화와 함께 고속 성장하는 동아시아 신흥국으로 외국인 투자 자금과 함께 핫머니(단기성 투가자본)가 대거 몰려들었지만 글로벌 자금 유입으로 통화가치가 오르면서 무역 수지가 악화하고 그로 인해 성장세가 둔화되면서 고속성장에 가려졌던 경제 구조적 문제가 불거져 나왔다. 

이는 지난 2008년 글로벌 금융위기 이후 미국을 포함한 선진국이 시장에 풀어놓은 막대한 유동성이 신흥국으로 유입됐지만 미국 연방준비제도(Fed)의 양적완화 축소 우려에 글로벌 자금이 썰물처럼 빠져나가는 현재와 닮아 있다.

글로벌 투자자들은 미국 출구전략에 따른 금리상승으로 신흥국 투자금에 대한 조달 비용이 높아질 수 있는데다 금리가 오른 미국 채권 등에 투자하기 위해 뉴욕행을 서두르고 있는 탓이다.

또 위기 발생 2~3년 전부터 신흥국의 외채가 빠르게 증가하고 경상수지 적자 폭이 확대되며 외환 보유액이 감소한 점도 위기의 전철을 밟고 있다.

태국은 1990년대 중반부터 경상수지 적자가 가중됐고 태국 주가와 바트화 가치는 위기 당시 50% 이상 폭락했다. 이는 현재 인도와 인도네시아가 대규모 경상적자에 시달리면서 통화가치와 주가가 폭락하고 있는 것과 중첩된다.

외환보유액이 감소하고 있는 것도 우려되는 대목이다. 16년 전 태국과 인도네시아, 한국은 환율 방어를 위해 외환보유액을 대거 풀어 환시장 개입에 나섰지만 위기 진화에 실패했다. 현재 미국의 양적완화 축소 움직임으로 신흥국의 외환보유액은 지난 5월부터 7월까지 3개월간 810억달러(약 91조원)가 증발했다. 이는 전체 신흥국 외환보유액의 2%에 해당한다. 

▶이번엔 다르다=하지만 2013년판 아시아 금융위기 우려는 1997년과 7가지 측면에서 다르다.

우선 환율제도가 다르다. 1990년대 신흥국들은 고정환율제를 시행했지만 현재는 대부분 변동환율제를 채택하고 있어 외화 수급에 따라 환율이 변동해 헤지펀드의 공격에 1997년보다 더 유연하게 대응할 수 있다. 

둘째는 높은 외환보유액이다. 1997년 외환위기 당시 80억 달러에 불과했던 한국의 외환보유액은 3300억 달러로 증가했다. 태국은 IMF 구제금융 신청 당시 외환보유고가 ‘제로’ 수준이었지만 현재는 1700억달러를 보유하고 있다. 

셋째는 단기외채 비중이 낮다는 점이다. 한국투자증권 전민규 애널리스트는 “단기 외채 비중이 높지 않고 외환보유액이 단기 외채에 비해 훨씬 많아 당장 위기가 발생할 가능성은 낮다”고 설명했다. 

실제로 1996년 말 태국과 인도네시아의 단기외채/외환보유액 비율은 각각 123%, 181%를 기록했다. 한국은 무려 228%에 달했다. 하지만 2013년 1분기 현재 태국과 인도네시아의 비율은 각각 35%와 46%로 낮아졌다. 한국과 인도도 각각 37% 수준에 머물고 있다. 

넷째는 금융시장의 투명성이다. 오늘날 모든 국가는 외환보유고나 부실채권 등 정보를 모두 공개하고 있다. 

다섯째는 신흥국의 경상수지가 엇갈리고 있는 점이다. 과거엔 인도, 인도네시아, 태국은 물론 홍콩, 한국, 필리핀이 모두 경상수지 적자 국가였다. 오늘날에는 인도와 인도네시아 태국 말레이시아가 경상 수지 악화를 겪고 있는 반면, 홍콩, 필리핀, 한국의 경상수지는 여전히 흑자를 기록 중이다.

여섯 째는 은행감독 시스템의 개선이다. 1990년대는 은행 감독 시스템은 탄생 초기여서 부실기업 대출이 횡행했지만 오늘날 아시아 금융권의 감독은 자동차부동산ㆍ소비자 대출 등 전분야에서 훨씬 엄격해졌다.

마지막으로 중국의 위상이 달라진 점도 주목할 만하다. WSJ은 “1997년 위기 전에는 일본이 아시아 각국의 경제성장을 견인했지만 2000년대는 중국이 세계 경제대국 2위로 올라섰다”며 외환보유액이 3조5000억 달러로 세계 1위라는 점을 상기시켰다. 

Posted by JsPark21
뉴스풀이2013. 8. 22. 17:30

기사의 요지는 '5% 병상 이상 외국인 환자 입원 금지' 규정, 병원은 숙박업을 할 수 없다는 규정 때문에 의료 서비스 수출 산업에 제한 받고 있다는 내용입니다.  결국 풀어달라는 건데, 풀면 국내 환자들이 입원할 병상이 부족해진다고 국가에서 반대하고 있답니다...


사실일까요?


제가 알기로는 수도권 대형병원들은 병상 부족이 맞고, 나머지 2,3차병원에서는 오히려 수요가 적어 빈 병상이 많습니다.  환자들이 수도권 대형병원에 입원하고 싶어하는데, 5% 규제를 푼다면 더 수익이 높은 외국인들에게 더 병상을 주고 싶어할 것이 분명합니다.  정부의 우려는 어느정도 현실적입니다.   '수익' 및 '경제발전의 명분'이 국민의 원하는 의료서비스를 받을 권리보다 약해 보입니다.  나중에 '외국인들 상대로 돈벌이 때문에 국민들 원하는 치료를 받지 못해 죽어난다' 이런 시츄에이션이 벌어질가능성이 높죠.  5% 룰은 반 시장적인 개입이지만 수도권 대형병원들에게는 규제를 가할 만 한 법입니다.


메디텔 규제는 호텔산업과 의료산업간의 밥그릇 싸움이 아닐까 하고 조심스레 추측해봅니다.  정부도 딱히 반대할 명분은 없어 보입니다.  외국인 환자 입장에서도 메디텔이 있으면 좋죠^^ 병원이랑 가깝고 좀 더 의료적인 부분에서 더 케어 받을 수 있을 테니까요.  그렇지만 이걸 허용하게 되면 호텔업 하시는 분들이 싫어하겠죠.  메디텔에 숙박하는 외국인은 병원에 굳이 입원할 정도는 아니지만 병원에 통원치료를 다녀야 하는 수준의 환자들일 거거든요.  지금은 이분들이 주변 모텔 및 호텔에 거주 하고 있기 때문에 밥그릇 싸움일 수 있다고 생각합니다.  메디텔이 생기면 아무래도 병원 통원도 쉬워질 것이고- 기본적인 의료케어 역시 좀 더 수월할 것이고 침상도 좀 더 환자에게 맞는 침상이 제공되는 등 메리트가 있겠죠.


증가하는 외국인 환자 수를 보면 흐뭇해지는 군요^^ 한국 의료서비스 시장은 블루오션임이 분명해보여요~~ 

잘 키워야 겠습니다!


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외국인 환자 늘면 내국인 병실 부족?…1950년대식 규제 버려라



저성장 늪에 빠진 의료산업 (下) 100만 외국인 환자 시대 열자

병실은 5%로 제한·메디텔 운영도 허용 안해
환자 100만명 유치하면 3만5천명 일자리 생겨

국내 병원들이 외국인 환자를 유치할 수 있도록 허용된 것은 4년여 전이다. 의료법이 ‘외국인 환자 유인 및 알선행위를 허용’하는 쪽으로 2009년 5월 개정되면서부터다.

보건복지부에 ‘외국인 환자를 유치하겠다’고 등록한 병원은 지난 6월 말 기준 전국 1811곳이다. 한국을 찾은 외국인 환자 수는 지난해 15만5672명으로 당초 목표치(15만명)를 넘어섰다. 한국 의료산업이 해외 수요를 개척하려는 의지나 능력은 어느 정도 확인된 셈이다. 

하지만 법과 제도는 여전히 의료산업을 ‘내수용’으로 규제하고 있다. 외국인 환자를 ‘봉’으로 보고 진료비를 바가지 씌우는 일부 병원의 행태도 문제다. 100만 외국인 환자 시대를 열려면 개선해야 할 것이 많다는 게 전문가들의 얘기다. 




○병실 5%만 외국인 배정

의료법에서는 국내 병원이 외국인 환자에게 배정할 수 있는 병실을 ‘전체 병실의 5% 이내’로 제한하고 있다. 외국인 환자가 증가하면 내국인이 입원할 수 있는 병실이 그만큼 줄어들 것이라는 우려에서다. 외국인 환자가 늘어나면 병원이 더 많이 생기고 의료산업 종사자에게 새로운 일자리가 늘어 의료산업이 발전할 것이라는 생각은 하지 않는다는 얘기다. ‘백성이 입을 옷을 만드는 데 필요한 광목이 태부족인데 외국에 내다 파는 게 말이 되느냐’며 수출을 반대했던 1950년대 시각이 아직도 지배하고 있다. 

병실을 구하지 못한 외국인 환자들이 “병원과 가까운 곳에 있는 호텔이나 모텔에 머물면서라도 치료를 받겠다”고 해도 국내 병원들은 받아들일 수 없는 상황이다. ‘의사들의 병원 밖 진료’를 법으로 금지하고 있기 때문이다. 해외는커녕 병원 문턱도 넘어서지 말라는 게 한국 의료산업 규제의 현실이다. 

최근 쟁점이 되고 있는 ‘메디텔(의료숙박시설)’ 문제도 마찬가지다. 의료 행위와는 무관한 상점 임대업은 병원이 할 수 있도록 허용하면서 환자들이 묵을 수 있는 숙박업은 엄격히 규제하고 있다. 이 때문에 외국인 환자를 돌보는 외국인 간병인이 머물 곳이 없어 애를 먹는 병원이 많다.

○외국인 진료비는 ‘병원 마음대로’

지난달 쌍꺼풀 수술을 받기 위해 한국을 찾은 중국인 의료관광객 왕모씨(27)는 관광만 하고 중국으로 돌아갔다. 왕씨는 “수술을 받기 위해 강남 성형외과 몇 군데를 다녀봤지만 치료비가 너무 차이 나 혼란스러웠다”며 “어느 병원이 잘하는지도 모르겠고, 바가지를 쓴다는 생각에 수술을 받을 수 없었다”고 말했다. 

서울 강남의 한 성형외과에서 통역 일을 하는 조선족 장모씨는 “외국인이 성형수술을 하면 한국인에 비해 두세 배 정도 바가지를 씌운다”며 “예컨대 쌍꺼풀 수술은 한국인이 하면 80만~120만원인 반면 중국인에겐 200만~250만원을 받는다”고 말했다. 이 때문에 한국 병원에 대한 외국인의 반감도 커지고 있다.

외국인은 건강보험 적용 대상자가 아니기 때문에 병원이 의료비를 공개하지 않는 한 얼마를 받는지 확인할 방법이 없다. 이 문제를 해결하기 위해 문화체육관광부는 내년부터 외국인 환자 진료수가를 온라인 사이트에 공개하도록 하고 시장가격에 대한 소비자 의견도 모니터링할 계획이다. 

○“의료산업 규제 풀어야”

지난해 치료를 받기 위해 외국으로 나간 세계 환자 수는 4000여만명으로 추산됐다. 의료기술이 좋고 진료비가 싼 곳을 찾는 환자가 매년 늘고 있다. 이들이 지난해 쓴 돈은 1000억달러(약 111조원)라는 게 시장조사기관의 추정이다. 의료서비스도 상품처럼 국가를 넘나드는 교역재로 바뀌는 시대인 셈이다.

한국의 의료관광 수입액은 지난해 2391억원(문체부 자료)이었다. 15만여명의 외국인 환자가 한 명당 평균 168만원을 의료비로 썼다. 

왕기영 문체부 국제관광과 사무관은 “지난해 해외 환자 유치실적(15만여명)만 놓고 보면 취업유발 효과가 5068명, 생산유발 효과는 4085억원”이라고 말했다. 의료관광객이 100만명으로 늘어나면 연간 3만5000명 이상의 고용창출 효과와 3조원이 넘는 생산유발 효과를 기대할 수 있다는 얘기다. 

하지만 한국의 의료산업을 국제화하려면 의료업계 전반의 규제 완화가 필요하다는 지적이 많다. 신영훈 한국의료관광협회장은 “의료산업에 대한 여러 규제 때문에 한국의 의료관광산업은 서울 강남에 있는 성형외과들에 지나치게 편중되는 문제 등이 생기고 있다”며 “선진국형 고부가가치 의료서비스가 활성화될 수 있도록 규제를 완화할 필요가 있다”고 말했다.


이준혁 기자 rainbow@hankyung.com

관광과 연계한 태국,진료에 스파·마사지 접목
무비자 입국 싱가포르,해외 홍보비 80% 보조

2011년 의료관광객 156만명을 기록한 태국의 의료 수준이 한국보다 높다고 보기는 어렵다. 태국의 많은 의사가 지금도 한국에 와 로봇 수술이나 내시경 시술을 배우고 있기 때문이다. 그럼에도 태국이 아시아에서 가장 많은 외국인 환자를 유치하는 국가로 성장한 데는 관광과 연계한 의료서비스와 정부의 정책 지원이 결정적인 역할을 했다.

태국은 성형이나 치과, 건강검진 등 의료서비스에 스파와 마사지를 접목시켰다. 태국에 가면 적은 돈으로 성형이나 검강검진은 물론 스파와 마사지 서비스까지 받을 수 있다는 인식을 갖게 만들었다.

태국 정부는 의료산업을 육성하기 위해 민간자본의 병원 운영을 일부 허용했다. 해외 환자를 유치하는 병원에 관세와 법인세를 감면하는 지원책도 내놨다. 이런 노력 덕분에 지난해 태국 의료산업(스파 포함) 매출은 150억바트(약 5437억원)를 기록했다. 태국의 의료산업은 2008년 글로벌 금융위기 이후에도 매년 7~10% 성장하고 있다.

싱가포르는 외국 환자들에게 무비자 입국을 허용하고 있다. 병원이 외국인 환자에게 받는 의료수입에 대해서는 세제 혜택도 제공한다.

해외 의료홍보비는 80% 보조해주고 있다. 외국인의 싱가포르 의료서비스 만족도는 80%에 이른다는 게 시장조사기관의 분석이다. 


ref: http://www.hankyung.com/news/app/newsview.php?aid=2013081885011

Posted by JsPark21