[The Typing Baker] The 'Best Healthcare System' Standing on a Precarious Tightrope

[Asia Economy Reporter Chunhee Lee] 'Truly Efficient Structure'

In this book that penetrates the entire Korean medical system, the author evaluates Korea's medical structure as follows. This is not a compliment. It is closer to irony, describing a structure that operates by inputting the minimum workforce and squeezing out the maximum output. There is no safety margin; only precise input and output occur. The author points out that the extreme pressure on nurses due to inexperience, known as the 'taeum' culture, and the abnormal structure where nurses who cannot perform surgeries directly handle scalpels as 'Physician Assistants (PA)' are also products of this system.

Implicit consent also underlies this structure. When receiving dispensed medicine, patients are supposed to get medication guidance from pharmacists. However, most patients visiting pharmacies prioritize quickly obtaining their medicine rather than listening to all instructions on how to take it. Without understanding why the standard '30 minutes after meals' is necessary, they simply take morning, lunch, and evening doses separately.

The author, who is a pharmacist and naturally exposed to various medical professions through family members?a doctor (younger brother), a nurse (mother), and a hospital staff member (father)?points out that the vulnerabilities of this structure became apparent during the COVID-19 pandemic. The six-person rooms, which 'efficiently' accommodated patients closely packed together, also efficiently accelerated virus transmission, causing catastrophic 'cohort isolation.' Vaccinations that only say 'It will sting' without informing about possible adverse reactions led to distrust in vaccines. On the other hand, patients who usually did not feel the importance of medication guidance quickly accepted telemedicine despite medical professionals' concerns.

Changes will accelerate further. Recently, cases where the National Health Insurance Service and the Health Insurance Review & Assessment Service strictly scrutinize fees and drug prices have increased. This is an expression of urgency. The government supports over 10 trillion won annually, barely sustaining the health insurance finances. To quote the author, "Current medical policies are barely balanced by relying on the young population." Since it is built on an unsustainable foundation, as the aging trend continues, this balance will eventually collapse suddenly.

What is the way to overcome this? The author focuses on 'money' and 'personnel' perspectives to propose measures. Fundamentally, reforming the fee system to ensure that actual personnel are deployed in less favored departments, and addressing spatial disparities by solving emergency medical issues first, are among the suggested approaches.

One of the frequently mentioned points when discussing Korea's medical system is that it has the best National Health Insurance system. However, this achievement has been made through an abnormally efficient structure funded by insurance premiums from the young working-age population. That structure cannot last. To talk about the 'post-COVID' era, discussions on the entire medical system must take place.

No Hospital for Old Age | Park Hanseul | Book Trigger | 184 pages | 14,500 KRW