Different Interests Among Sectors Over Authority and Composition of Medical Supply and Demand Estimation Committee (Comprehensive)

Medical Community: "Decision-Making Authority Needed" vs Patient Groups: "Should Be Limited to Deliberation"
"Majority Should Be Professionals" vs "Difficult to Ensure Fairness of Results"

Opinions diverged among various sectors during a public hearing on the authority and composition of the medical workforce supply and demand estimation body being promoted by the National Assembly. The medical community argued for a composition with voting rights and a majority of professionals from the relevant fields. On the other hand, patient and consumer groups expressed concerns that the authority should be limited to deliberation and that if professionals from the relevant fields constitute the majority, it would be difficult to guarantee the fairness of the results.

On the 14th, a public hearing was held at the National Assembly's Health and Welfare Committee for the legalization of the medical workforce supply and demand forecasting organization. Photo by Yonhap News

According to the Health and Welfare Committee of the National Assembly on the 14th, 12 witnesses including the Korean Medical Association (KMA), the Korean Hospital Association (KHA), academia, and patient and consumer groups attended the public hearing for the legalization of the medical workforce supply and demand estimation body and expressed their opinions on the related bills.

The related bills currently submitted to the Health and Welfare Committee focus on discussing the appropriate scale of medical personnel through the Medical Workforce Supply and Demand Estimation Committee (Estimation Committee) to increase social acceptability. However, there are differences in the methods of composition and authority of the Estimation Committee.

Participants in the public hearing showed differing views on the authority of the Estimation Committee. Opinions also diverged on whether the Estimation Committee should be placed under the government’s Health and Medical Workforce Policy Deliberation Committee (Recognition Committee) or Health and Medical Policy Deliberation Committee (Policy Committee), or operate independently.

The medical community argued that the Estimation Committee should be established as an independent decision-making body with final decision-making authority. Ahn Deok-seon, director of the Medical Policy Research Institute of the KMA, said, "I am absolutely opposed to placing it under the Policy Committee," adding, "To ensure independence, neutrality, transparency, and expertise, it should be a non-governmental statutory organization or a corporation and must secure its own voting rights."

Kim Min-su, policy director of the KMA, also said, "It must be an independent organization," and added, "Medical policy deliberations should be conducted scientifically and transparently by experts in an independent intermediary organization."

Jang Won-mo, professor of public medicine at Boramae Hospital, said, "Among the six revised bills related to the establishment of the Estimation Committee, three specify the committee’s deliberation and voting authority," and added, "To ensure stable and continuous operation of the committee, it is necessary to establish a legal basis allowing the committee to deliberate and decide on matters necessary for workforce supply and demand management."

There were also arguments against granting voting rights to the Estimation Committee. Ahn Ki-jong, representative of the Patient Organization Federation, said, "The role and authority of the Estimation Committee should be limited to deliberation, not decision-making," and proposed, "The Recognition Committee and Policy Committee, which are social consensus bodies, should reflect the results of the Estimation Committee and deliberate accordingly."

Shin Young-seok, research professor at Korea University Graduate School of Public Health, stated, "The Minister of Health and Welfare should adopt the supply and demand estimation results of the Estimation Committee unless there are special reasons," and added, "The Estimation Committee should serve as an advisory body that deliberates on estimation results and proposes policies, while the government should make the final decisions."

A compromise was also suggested. Ok Min-su, associate professor of preventive medicine at Ulsan University College of Medicine, said, "Considering the status issues among committees, it is not easy to grant voting rights to the Estimation Committee," and added, "Instead, to give sufficient authority to the Estimation Committee, it should be stipulated that the Policy Committee must reflect the Estimation Committee’s deliberation results, or if voting rights are granted, the Policy Committee should be able to request a re-examination of the estimation results."

Jung Jae-hoon, professor of preventive medicine at Korea University College of Medicine, said, "The Estimation Committee should not remain merely an advisory body, but it is also difficult to consider a system where the Estimation Committee’s decisions are immediately finalized as ideal," and mentioned, "Practically, it is worth considering a procedure that requires the government or National Assembly to explain the reasons when they do not accept the recommendations or estimation results derived by the Estimation Committee."

Different claims were also made regarding the chairperson and member composition of the Estimation Committee. Director Ahn Deok-seon said, "The chairperson of the Estimation Committee should be an expert appointed, not a government member, and at least two-thirds of the members should be professionals from relevant fields such as doctors."

Policy director Kim Min-su emphasized, "The chairperson of each Estimation Committee should minimize cases where a Ministry of Health and Welfare official holds an ex officio position or is appointed."

Jang Bu-seung, a social policy comparative expert and professor at Kansai Gaidai University in Japan, said, "As in the case of Japan, our Estimation Committee should also be composed of at least three-quarters licensed doctors such as private practitioners, medical school professors, and hospital administrators with experience, and the recommendation rights for licensed doctors should be granted to medical associations."

However, patient and consumer groups hold different positions. Representative Ahn Ki-jong said, "The Estimation Committee should be composed of experts recommended equally by healthcare provider groups and consumer groups," and added, "If provider group recommended members constitute the majority, it is difficult to guarantee the fairness of the deliberation results."

Kang Jeong-hwa, president of the Korea Consumer Federation, said, "I do not oppose the composition of members recommended by occupational groups, labor, patient, consumer groups, and academia, but I have concerns about provider side recommended members constituting the majority of the Estimation Committee."

Meanwhile, there were also claims that these discussions on the Estimation Committee are hollow. Heo Yoon-jung, professor at Dankook University Hospital Regional Trauma Center, said, "I express gratitude and respect for opening the discussion on the medical workforce estimation bill," but added, "The remaining golden hour has all been exhausted, so these discussions feel hollow to me who works on the front lines."

She continued, "Doctors who fail to save lives are treated like criminals who caused injury. Because of this, young doctors have decided not to undergo further training," and added, "Regardless of today’s discussion, this is about the special exemption clause for medical lawsuits against residents."