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  1. 2006/04/15
    Mission : Impossible?
    시다바리
  2. 2006/04/13
    내부기관 장애인
    시다바리

Mission : Impossible?

 

Mission: Impossible?

Rob Portman tries to navigate the trade shoals.

by Irwin M. Stelzer

04/11/2006 12:00:00 AM


ROB PORTMAN has a tough job. As United States Trade Representative he does have the rank of ambassador and a staff of over 200 (considered tiny by the standards of Washington's bloated agencies). That, and the fact that he is siding with the angels by fighting for freer trade, must be a comfort on a cold night after wearying negotiations with developing countries, some of whose grievances he knows to be legitimate, and with his E.U. counterpart, Peter Mandelson, ever-ready to, er, reinterpret the meaning of his most recent concessions.


Portman, mild-mannered and not given to hyperbole, characterizes the current trade environment as "a challenging time." He knows that the global Doha round is in serious trouble. If a deal cannot be struck by July 1, 2007, the president's authority to put it to Congress on a take-it-or-leave it basis will expire, and with it the chance for congressional approval.


Two of the stumbling blocks are agriculture and services. President Bush has offered to eliminate all trade-distorting agricultural subsidies if America's trading partners will do the same. That has been greeted by the European Union, with France in the lead, with as much enthusiasm as French students have for private-sector jobs that don't promise life-time employment. Worse still, Mandelson has presented that position to Portman as non-negotiable. That leads Rep. Bill Thomas, a staunch free trader and ally of the president in his fight to open markets, to conclude that the U.S.-E.U. differences are irreconcilable, "and when you have irreconcilable differences the best thing you can do is call it [the Doha round] off."


Services, which include everything from finance through lawyering and insurance, are one of America's strongest export sectors. In documents released last week Portman points out that the United States runs a $56 billion surplus in trade in services despite barriers erected by developing countries, and that liberalization of such trade "could account for fully 72 percent of the economic gain from the Doha round." But the developing countries are about as ready to open their insurance and other markets as the French are to abandon agricultural protection.


Although he still hopes to salvage the global Doha round, and the Australians are trying mightily to help him do that, Portman knows that his best hope is to concentrate on bilateral rather than broader, multinational, agreements. So he is relying on individual deals with countries that account for 54 percent of U.S. exports. With good results: exports to those countries that have signed on have grown at twice the rate of exports to the rest of the world. More such deals are in the works, with countries ranging from Peru to Malaysia to Panama to Korea and--surprise--with the United Arab Emirates, home of Dubai World Ports.


That Portman can make such progress is a testimonial to his negotiating skills, and not only with America's trading partners. Nipping at his heels are environmentalists, who worry more about fish and forests than about the economic growth that freer trading brings (and on which environmental preservation ultimately depends) and trade unions, who disguise their protectionism by professing concern for the working conditions of laborers in Asia and Central America. The unions would have us stop trading with countries that fail to adopt the high-cost U.S. standards that are inappropriate to their circumstances and would surely make most developing countries uncompetitive in world markets.


 Then there is Congress, some of whose members, their sights set on the November elections, are distinctly uneager to antagonize constituents that might be adversely affected by imports. Others profess worries about the national security implications of increased reliance on imports, and acquisitions of U.S. firms by foreigners.


Finally, there is China. On April 20, China's President, Hu Jintao, will visit Washington. The date is significant, because some time this month the Treasury must issue its semi-annual list of currency manipulators. It is doubtful that the approximately 3 percent rise in the value of yuan against the dollar, allowed by the Chinese since they relaxed the yuan-dollar peg, will satisfy congressional critics who want China included on the list, with retaliatory measures to follow.


Bush is concerned not only with the negative effects such retaliation would have on the economy--prices would rise, forcing interest rates still higher, creating pain for a softening housing market. He also fears that such targeted protectionism would dash his already slim hopes of converting China from a geopolitical rival into a partner in maintaining a stable world order.


So the administration has launched a campaign to downplay the significance of America's $202 billion trade deficit with China. Commerce Secretary Carlos Gutierrez told a business forum in Tokyo that America's robust economy has nothing to fear from China's low-cost manufactured products. Administration spokesmen also point out that many made-in-China products are produced in factories owned by U.S. companies, and that products imported from China were manufactured elsewhere in Asia and merely assembled in China.


The Chinese helped by inviting to Beijing two of their severest critics, Senators Chuck Schumer and Lindsey Graham, and persuading them that they will indeed revalue gradually. So the senators have agreed to delay their bill to levy a 27.5 percent tariff on Chinese imports.


But all is not sweetness and light. The United States and the European Union have followed the imposition of quotas on several Chinese products (bras, panties, shoes, trousers) with an appeal to the WTO to declare China's tariffs on imported auto parts a violation of the organization's rules. More important, China's ongoing massive theft of American intellectual property has the influential software and entertainment industries up in arms. They want the president to tell the visiting Chinese to respect their intellectual property rights or face a closing of the American market that is so crucial to China' ability to grow its economy, create jobs, and avoid a social upheaval that might create the sort of unemployment that the Chinese most fear--the turning out of office of the current regime.



Irwin M. Stelzer is director of economic policy studies at the Hudson Institute, a columnist for the Sunday Times (London), a contributing editor to The Weekly Standard, and a contributing writer to The Daily Standard.


진보블로그 공감 버튼트위터로 리트윗하기페이스북에 공유하기딜리셔스에 북마크

내부기관 장애인

1999년 신장장애인, 심장장애인

2003년 간장애, 배변기능이상을 뜻하는 장루요루 장애, 간질 장애, 호흡기 장애

 

내부기관장애 현황

 

경상대 정백근, 부산대 윤태호 교수의 연구보고서에 의하면 지난 2005년 6월말 현재, 우리나라 내부기관장애인 등록자수는 총 8만2729명으로 전체 등록장애인(169만9329명)의 4.87%에 해당된다. 이 가운데 신장장애인이 4만288명으로 가장 많고, 그 다음으로 심장 1만2226명, 호흡기 1만815명의 순으로 조사됐다.

또 장애를 외부 신체기능장애ㆍ내부기관장애ㆍ정신적장애로 범주를 나눴을 때 장애 1, 2급에 해당되는 중증장애인 비중은 정신적장애가 가장 높게 나왔으며 내부기관장애도 53.4%의 높은 비율을 차지했다.

특히 신장장애(82.7%)는 정신적장애(69.7%)보다 높은 비율을 차지해 중증장애 비율이 가장 높은 것으로 드러났다.

 

장애등급판정기준 및 장애인 등록과정의 문제점

정 교수 연구팀은 보고서에서 내부기관장애의 등급 판정은 지난 2003년 제정된 장애판정기준에 따르고 있으나 전문가들 사이에서 개정의 필요가 많이 제기되고 있다고 밝혔다. 특히 다른 장애와 달리 필수적인 재판정의 시기와 방법이 지나치게 규제 위주여서 개선이 필요하다는 의견이 많다고 한다.

내부기관장애인의 경우 장애정도나 기능수준이 질병 치료수준에 따라 많은 영향을 받을 뿐 아니라 의학 발전과도 직결되므로 판정기준의 정기적인 재컴토가 필요하다는 지적도 있다.

 

빈곤과 불건강의 악순환의 고리

정 교수 연구팀의 심층면접조사 결과 내부기관장애인들이 평균적으로 병에 걸려있는 기간이 17.3년으로 상당기간 질병 때문에 고통을 받고 막대한 의료비가 지출되고 있음을 알 수 있다.

내부기관장애인 중 연간 입원환자 당 법정본인부담금은 83만4051원으로 비장애인(28만5762원)의 3배 이상이며 신체기능장애ㆍ정신적장애인(53만4913원) 비해서도 월등히 높은 것으로 나타났다. 내부기관장애의 유형별로 살펴보면 간장애인 42만4762원, 심장장애인 37만7052원, 신장장애인 33만6412원, 간질장애인 13만4777원으로 조사됐다.

조사 대상자 중 진단 후 1개월이 넘어서 치료를 받은 사람이 약 62%였는데 경제적 어려움때문이라는 이유가 가장 많았다. 진단 직후 치료를 받았다 해도 현재 치료를 받고 있지 못하다는 사람과 현재 치료를 받고 있다 할지라도 충분한 치료가 이뤄지지 않고 있다는 사람도 모두 경제적인 이유라고 답했다. 특히 장애 후 질병으로 인한 가계파탄으로 기초생활보장수급 대상자가 된 경우가 89%에 이르러 내부기관장애 발생에 따르는 경제적 부담이 큰 것으로 밝혀졌다. 이는 대부분 가족의 부담으로 연결되고 있기 때문에 궁극적으로 내부기관장애인에 대한 정부차원의 소득보전과 의료비지원이 시급함이 입증된다.

한국신장장애인협회 관계자는 “내부기관장애인들 중에는 국민기초생활보호대상자에 들기 위해서 경제활동능력이 있는 가족들과의 해체를 선택하는 경우도 있다”며 “내부기관장애인들을 위한 별도의 의료급여로 책정하거나 현재 비급여항목인 장루장애인들의 보장구를 급여항목으로 지정해야한다”고 말했다.

 

27일 경상대 정백근 교수와 부산대 윤태호 교수가 발표한 '내부기관 장애인 설 문조사 및 심층면접 조사결과'에 따르면 내부기관 장애를 겪은 설문 응답자(233명) 의 24.9%가 장애 전 건강보험 가입자였다가 장애 뒤에는 의료급여를 받아야 하는 기초생활보장 수급자로 전락한 것으로 나타났다.
장애 후 의료보장 자격이 바뀐 장애인 중 89%는 질병으로 가계가 파탄에까지 이 르렀다.
또 응답자의 약 20%는 장애 후 사회계층이 하락한 것으로 나타났다.
내부기관장애인들이 장애질병 발생 뒤 의료급여 대상자로 바뀌는 기간은 평균 6 5.8개월이었고 이들이 질병을 앓는 기간도 평균 17.3년에 달했다.

 

 

 
진보블로그 공감 버튼트위터로 리트윗하기페이스북에 공유하기딜리셔스에 북마크