Political and economic interests are intertwined, behind the deadlock in South Korea's medical reform

　　In the past few days, the storm of doctors' resignations triggered by the South Korean government's announcement of a new medical reform plan has intensified amid the conflict between the government and the medical community.

Some analysts believe that this fierce confrontation once again reflects a series of deep-rooted shortcomings such as seniority difficulties and structural imbalances in South Korea’s current medical system.

　　one

　　According to media reports, statistics released by South Korea’s Ministry of Health and Welfare show that as of February 26, more than 10,000 interns and residents have resigned from South Korea’s 100 large general hospitals, accounting for 80.5% of all interns and residents in these hospitals. %.

　　In addition, more than 13,000 medical students in Korean universities (70% of the total) joined the protests and applied for suspension of study. Some medical university graduates also gave up their internship employment contracts.

　　The South Korean government has reportedly raised the country's medical crisis to the highest "severe" level.

Among the major hospitals in Seoul, surgeries at Yonsei University Severance Hospital and Gangnam Severance Hospital have been reduced to half of normal times; Samsung Seoul Hospital and Seoul Asan Hospital have reduced operations to 45%~50% and 40%~50% respectively. .

Many hospitals are struggling to operate due to staff shortages.

　　It is worth noting that junior doctors such as interns and residents were the main force in the resignation of the incident. About two-thirds of South Korea's junior doctors joined the protest.

　　The Korean healthcare system relies heavily on junior doctors as they play a key role in emergency and acute care.

Statistics show that junior doctors in the five major hospitals in Seoul account for about 40% of the total number of doctors.

　　The Korean Medical Association conducted a survey and found that junior doctors work up to 80 hours a week, nearly 30 hours more than formal specialists.

At the same time, their average income is much lower than that of specialists.

　　Almost all formal doctors in South Korea are employed for life, while interns and residents not only work hard and have a significant gap in salary levels before they obtain formal status, but their futures are also unstable. This is different from what medical students have experienced in the past ten years or so. The hard work put in makes a huge difference.

　　This time the South Korean government has launched a reform plan with a large-scale expansion of medical student recruitment as the core measure. For junior doctors and even university medical students who are already studying, it means that they will have more opportunities in the future on their way to becoming regular doctors. Competitors; even some hospitals may give up hiring junior doctors who are about to become full-time doctors in order to reduce employment costs, and instead accept more interns and residents to supplement their manpower.

　　two

　　Facing the raging wave of opposition from doctors, the South Korean government currently shows no signs of compromise.

　　On February 28, South Korea’s Ministry of Health and Welfare issued return-to-work orders to some representatives of interns and residents who had left their jobs.

The South Korean government has previously stated that it will complete inspections of the attendance of interns and residents in 50 large general hospitals within this week, and requires interns and residents who have resigned to return to work before February 29. From March, Relevant judicial measures such as revoking medical licenses will be taken against interns and residents who fail to return to work.

　　South Korea's "Medical Law" stipulates that when the government discovers that public health is facing serious risks, it can order doctors to return to work. Those who violate the order may be banned from practicing medicine for less than one year, or even be sentenced to fixed-term imprisonment of less than three years, and their medical licenses will be revoked.

　　On February 27, the Ministry of Health and Welfare of South Korea reported to the police five people including relevant personnel of the Emergency Response Committee of the Korean Medical Association on suspicion of violating relevant provisions of the Medical Act and obstructing official duties.

South Korean media pointed out that this move means that the South Korean government’s “principled response” to the collective resignation of doctors has officially begun.

　　In addition, South Korea's Ministry of Education issued an official document to all universities, requiring medical students who participated in the "collective strike" to be dealt with in accordance with regulations, and emphasized that there will be no "post-incident remedies."

　　While exerting pressure to resume work, the South Korean government is also actively allocating resources to avoid the collapse of the medical system.

South Korean Prime Minister Han Deok-soo said that the South Korean government will send 150 public health doctors for essential medical care and 20 military doctors to large general hospitals to provide reinforcements in mid-March.

In order to successfully activate the emergency medical treatment system, the government will allocate additional support reserve funds.

　　On February 23, the South Korean government established the Central Disaster Safety Countermeasures Headquarters headed by the Prime Minister, launched an inter-departmental response system, and comprehensively expanded remote diagnosis and treatment services from that day on.

The South Korean government has decided to open the emergency rooms of 12 military hospitals to the public and temporarily adjusted the business scope of nurses to provide legal protection for nurses to undertake part of the work of doctors.

　　On the other side, the medical group led by the Korean Medical Association has no intention of compromise and condemns the government's continued pressure on doctors.

The Emergency Countermeasures Committee of the Korean Medical Association recently stated that if the government forcibly implements the plan, the medical community will use all legal means and methods to resolutely resist it.

The association said that the national doctor mobilization meeting planned for March 3 will become the "starting point of the great long march" against government policies.

　　three

　　Behind the stalemate between the Korean government and the medical community, there are complex political demands, economic interests and other motivational factors.

But at the same time, the two sides' different views on the current shortcomings of South Korea's medical system and effective solutions are also an important reason for the differences.

　　The South Korean government has repeatedly stated that the ratio of the number of doctors to the total population in South Korea is the lowest among developed countries.

Coupled with the fact that the birth rate is at the bottom of the world, the population is aging, and medical needs are increasing, South Korea will have a shortage of 10,000 doctors in 2035, so medical universities must expand their enrollment.

　　South Korean President Yoon Seok-yue previously said that in the past 27 years, the government has failed to allow medical schools to expand their enrollment by one person, and increasing the number of doctors is crucial to preventing the collapse of basic medical services.

　　However, the medical community believes that the medical reform policy of expanding enrollment cannot solve the problems of shortage of medical personnel and uneven resource distribution. The biggest problem in South Korea's medical industry is not the insufficient number of doctors, but the uneven distribution of medical resources.

　　A survey of more than 20,000 members of a medical association showed that 95% of the respondents disagreed that "South Korea is short of doctors."

　　South Korea's medical system is highly privatized, and more than 90% of hospitals are private. Although the public has a high level of medical insurance, South Korea's medical resources are highly unevenly distributed.

　　For a long time, medical resources have been unbalanced in central South Korea. There are 1.59 doctors per 1,000 residents in Seoul, which is more than three times that of Chungcheongnam-do and Jeollanam-do.

At the same time, low-risk, high-profit fields such as dermatology and plastic surgery are booming, while emergency departments, surgery, pediatrics, obstetrics and gynecology and other fields are severely understaffed.

　　The doctor group believes that if the government cannot effectively improve the current working environment of doctors in remote areas and disadvantaged fields by expanding financial compensation, reducing liability for medical malpractice, and formulating systematic support plans for local medical care, then it will simply expand the number of doctors. , cannot solve the problem of uneven distribution of doctors, but will lead to excessive competition and make the distorted medical system worse.

　　However, a recent poll shows that 76% of the respondents believe that the policy of expanding medical student enrollment "has more benefits than disadvantages", and more than 80% of South Korean people support the government's tough stance on striking doctors.

It can be seen that the majority of South Korean people support the government's reform measures this time.

　　Liang Fan