[The Editors' Verdict]There Is a Different Direct Approach to Resolving the Medical Crisis

At the end of May, when next year's medical school enrollment increases were allocated by school, a senior government official confidently told me, "If we give benefits to residents who return resigned, collective action will lose its power." However, the residents did not budge, and his prediction was wrong.

On the 22nd, the government began the 'autumn turn (September resident recruitment)' and even allowed resigning staff from regional hospitals to transfer to large hospitals in Seoul to encourage their return, but it seems this will end in vain. Residents remain unresponsive, and the medical community is obstructive. Seoul National University Hospital, Busan National University Hospital, and others applied for recruitment in a token manner. Professors from the 'Big 5' medical schools refused to train autumn residents from other hospitals. The cartel that ignores the normalization of medical services and only looks after their own disciples shows no end.

According to our investigation, the number of deaths from February to April this year increased by 7% compared to the same period last year. Monthly deaths decreased by 3.2% and 0.5% in December last year and January this year, respectively, but began to increase from February when the medical crisis started. It cannot be ruled out that the reduction in treatment for severe diseases due to medical vacancies had an impact. We cannot help but criticize the collective selfishness of the medical community that has forgotten Hippocrates.

The government’s failure, which turned the doctor group?the direct policy target of medical reform?into an adversary and nurtured the seeds of conflict, must also be pointed out. Only by reviewing the fundamental causes of failure can recovery be possible.

The root cause is the long-standing distrust of the government by the medical community, which the government itself provoked. When I covered the 2000 separation of prescribing and dispensing of medicines, I repeatedly heard the medical community claim that "health insurance expenditures will skyrocket." When I asked government officials, they dismissed it, saying "That won't happen." However, health insurance expenditures surged in 2001 when the separation was fully implemented. In response, the government cut medical fees by 2.9% the following year. The resident who witnessed this cut is now a medical school professor in his 50s.

Returning to this year, the medical community argues that increasing medical school enrollment will cause health insurance expenditures to surge, while the government denies it. Because of this, doctors see the government as shaking a candy that it gave and then took away, both then and now. The Ministry of Economy and Finance rejected the Ministry of Health and Welfare’s third supplementary budget request for the medical crisis earlier this month. Therefore, doctors suspect that improvements to resident training environments and increases in essential medical fees will disappear once residents return.

The government must soothe the medical community and embrace it within the policy framework. The strategy of appealing while holding both carrot and stick and waiting has proven ineffective. The government must take the initiative to build trust. The straightforward approach is to respond with action to the question, "With what money will essential medical care be saved?"

The Ministry of Health and Welfare has promised to present a financial investment roadmap for medical reform by next month. A roadmap alone does not generate funds. The Ministry of Health and Welfare and the Ministry of Economy and Finance must fully allocate the budget for essential medical support and persuade both ruling and opposition parties to pass it in the autumn regular session of the National Assembly. If additional health insurance burdens are inevitable, they must begin amending the National Health Insurance Act to raise the upper limit of health insurance premiums. Public persuasion must also proceed alongside, such as the message "We agree to medical school enrollment increases but want health insurance premiums lowered" (Korea Employers Federation, 2024 Health Insurance Issue Awareness Survey). The Ministry of Education must also immediately invest in education for next year’s increased enrollment.

This is not an easy task. Still, if the ministers and vice ministers of related departments roll up their sleeves and work hard to secure funding, I believe the medical crisis can begin to be resolved.