Mass Walkouts on the 18th Different from 2000, 2014, and 2020... Why Has Public Opinion Turned Cold? [Urgent Review of Legislative Conflict] (Part 2)

Public Opinion Cools Compared to Past General Strikes
Lacking Both Justification and Practical Benefits
Prevailing View of Occupational Self-Interest
Standoff Leads to Mutual Destruction
Must Form Council to Derive Negotiation Proposal

Editor's NoteThe conflict between the government and the medical community has entered its fourth month, with medical students, residents, and now professors joining collective strikes, prolonging the extreme standoff. The Korean Medical Association (KMA) is taking a hardline stance demanding a complete reconsideration of the medical school enrollment increase, while politicians are fiercely criticizing doctors as a ‘privileged elite group protecting their occupational interests.’ Public concern over a medical disaster is growing. In this context, at the point when the 1,500 medical school enrollment increase for 2025 has been confirmed, this article urgently examines the remaining critical issues of medical reform. As the government-medical conflict edges toward a crisis, it sheds light on the essence, core, and immediate issues of medical reform, outlining priorities and future alternatives.

Although the KMA has announced a collective strike scheduled for the 18th, public opinion remains cold. The prevailing view sees this general strike by doctors, who are symbolized as ‘high-income professionals,’ as an effort to ‘protect vested interests.’ In fact, a survey of 1,000 citizens revealed that 85.6% believe ‘doctors should stop collective actions and return to their patients.’

Even within the medical community, many voices consider the KMA’s demand for a ‘complete reconsideration’ of the 1,500 enrollment increase for 2025?which has already been announced through the Ministry of Education and university admissions guidelines?as unrealistic.

Professor Jeong Hyeong-seon of Yonsei University’s Department of Health Administration told this publication, “This increase should be seen as the government’s response to the shortage of medical personnel,” adding, “Demanding to nullify this irreversible decision is unreasonable.” There is also a compromise view suggesting that since the 2025 increase is confirmed, negotiations with the government should focus on adjusting the number of medical school enrollments for the following year, 2026. A professor at a university hospital noted, “Even if the KMA’s demand for a complete reconsideration were accepted, resistance from 500,000 examinees would be formidable, causing greater confusion.”

Public Opinion Cooler Compared to Past Strikes...Lacking Both Justification and Practical Benefit

Above all, the consensus is that this general strike differs in nature from past cases such as in 2000 (separation of prescribing and dispensing), 2014 (telemedicine), and 2020 (medical school enrollment increase). Public opinion is overwhelmingly on the government’s side amid a deadlock with no compromise in sight. During the 2000 separation of prescribing and dispensing under the Kim Dae-jung administration, 92% of local clinics closed and residents submitted resignation letters en masse, but the government raised fees, improved resident salaries, and proposed a 10% reduction in medical school quotas to reach a compromise. The 2014 strike opposing telemedicine under the Park Geun-hye administration ended with a pilot project agreement. The 2020 medical school enrollment increase under the Moon Jae-in administration was nullified after reconsideration, but that case involved the exceptional variable of the COVID-19 pandemic.

Hardliners pushing for the strike cite broader issues in medical services such as ▲the commercialization of healthcare under infinite competition, ▲insufficient investment in public healthcare, and ▲chronically low medical fees. The cost-effective healthcare system established in 1977, funded by health insurance premiums, is now reaching its limits. The poor business structure of university hospitals is also cited as a reason for opposition. Residents have endured low wages and long working hours with the expectation of future economic rewards and high social status, but the enrollment increase decision weakens these incentives and motivations.

However, some argue these issues should be viewed on a different track. A professor at a general hospital, speaking anonymously, said, “Public hospitals like Seoul National University Hospital have already started indefinite strikes, but expanding the front based on the public healthcare system or overall healthcare marketization at this point is cynicism that has been around for 20 years. Opposing medical reform on that basis is a distraction from the main issue.”

Mutually Escalating Standoff Leads to Mutual Destruction...An 8-Member Council Should Be Formed to Derive Negotiation Proposals

[Image source=Yonhap News]

Inside and outside the medical community, there is a call for both the government and the medical sector to take a step back. If the government and medical community continue a ‘power struggle’ standoff, finding common ground will become difficult. Especially, the consensus is that the government’s hardline approach?pressuring university presidents to deny leave of absence approvals or issuing excessive administrative orders?does not help resolve the situation.

Professor Jeong said, “Depending on perception, the participation rate of doctors (private practitioners) or professors in the strike may not be high,” adding, “The government should also refrain from administrative orders and accept students’ leave of absence applications.” Professor Park Eun-cheol of Yonsei University’s Department of Preventive Medicine suggested, “Doctors should explain the justification for collective action to the public in the form of a public address or hold discussions to supplement the essential medical service package.” A university hospital professor, speaking personally, stated, “It is time for representatives from the National Medical School Professors’ Council (Jeonui Gyohyeop), the Korean Intern Resident Association (Daejeonhyeop), the Korean Medical Students Association (Uidae Hyup), and the Korean Medical Association (Uihyeop)?two representatives each?to form an 8-member committee to produce a unified proposal.”

Above all, criticism is mounting that the medical community is not listening to the voices of 92 patient organizations. At a press conference held at the National Assembly on the 13th, patient groups urged, “Patients have suffered great anxiety and harm due to the prolonged medical vacuum caused by collective actions over the past four months,” and strongly demanded, “The strike threatening patients’ lives and health must be withdrawn.”

Series Outline

<上>The Medical School Boom, but 7,625 Students Overlapping Classes...Concerns Over Education Quality
<中>The Enrollment Increase Is Irreversible; Fee Increases and Medical Accident Special Act Reinforcement Are Key
<下>The General Strike on the 18th Differs from Those in 2000, 2014, and 2020...The Medical Community Must Engage in Dialogue with the Public