[Series] The 'Uncomfortable Bill' of Jeju's Top-Tier Hospital as Seen by a Cancer Patient Reporter (Part 1)

[Part 1] The Illusion of "Medical Independence"
Provincial Government Admits "20% of Severe Patients Inevitably Transferred to Seoul"... Acknowledges Limits of Medical Independence
Choi Gukmyung, Jeju Hospital Director, Concedes "Medical Travel Won't Decrease Immediately"
Cancer Patients Remain Distrustful: "Even If Given Another Choice, I'd Still Seek Treatment in Seoul"

Editor's Note

Contrary to expectations that the designation of a top-tier general hospital in Jeju would lead to "medical independence" for the island, concerns are mounting that it may only result in a "cost bomb" for residents. Over the course of two articles, a cancer patient and reporter will share firsthand experiences from the medical field during more than two years of treatment.
Even administrative authorities and hospital officials have acknowledged the inevitability of severe patient outflow. This series will examine the structural contradiction in which medical fees rise without the necessary infrastructure and essential medical staff. In particular, it will highlight the disappearance of psychological stability and human rights for severe patients in the treatment process, aside from medical technology, and reflect the strong public opinion that securing real medical capabilities for "those who cannot go to Seoul" must take precedence over upgrading hospital status simply to cover deficits.

With the separation of Jeju's medical service area virtually confirmed, the likelihood of Jeju's first top-tier general hospital being designated has increased. However, both Jeju Provincial Government and hospital officials have officially admitted that this designation will not guarantee a "self-sufficient medical system" on the island. This reality stands in stark contrast to residents' expectations that "once designated, patients will no longer need to go to Seoul." Even before it begins, concerns are already dominant among the public.

The exterior view of the so-called 'Big 5' metropolitan area tertiary hospitals in South Korea,

Jeju Province: "10-20% of truly severe patients will inevitably have to go to Seoul"

A member of the Jeju top-tier general hospital task force recently told this reporter, "Even if the hospital is designated as a top-tier facility, it will not be possible to fundamentally prevent the outflow of patients to Seoul."

This official explained, "For 10-20% of patients with truly severe or rare diseases, it is a reality that they must go to the 'Big 5' hospitals in Seoul," adding, "This designation effort is intended to accommodate the remaining 80% of patients within Jeju." In effect, the authorities have internally acknowledged the impossibility of achieving "perfect medical independence."

Choi Gukmyung, Director of Jeju National University Hospital, also predicted at a meeting on January 14 that "medical travel to the mainland will not decrease immediately," admitting that even if a top-tier hospital is designated in Jeju, reliance on metropolitan medical services will persist for the time being.

In fact, indicators reflecting trust in local medical services have actually declined. According to Park Hyungkeun, Deputy Director of Public Healthcare at Jeju National University Hospital, the self-sufficiency rate (RI) for local patients has dropped from 85% in the past to about 82% now. This shows that patient outflow is accelerating even as the designation of a top-tier hospital approaches.

"Even if I get sick again, I will definitely go to Seoul"... The Distrust at the Early Morning Airport

These concerns from the authorities are starkly evident in the field.

In the early morning hours at the third-floor departure lounge of Jeju Airport, unlike tourists dragging flashy suitcases, there are people wearing hats pulled low, scarves wrapped tightly, and masks, walking wearily.

These are patients traveling for treatment, boarding flights at almost the same time to head to the "Big 5" hospitals in Seoul.

Over more than two years of outpatient cancer treatment, this reporter asked fellow cancer patients, "If your cancer recurred or if an acquaintance was diagnosed, would you recommend a hospital in Jeju?" The unanimous answer was, "I would absolutely go to Seoul," and "I would never recommend a hospital in Jeju."

In this situation, I want to raise practical issues and call for solutions. Those with financial means and physical ability can go to Seoul, but the real problem is for residents who cannot afford to go.

If a top-tier hospital is designated in Jeju, the priority should be to develop the capacity to "definitely save those who cannot go," rather than focusing on "retaining those who would go to Seoul."

The Structural Limits of a 'Standalone Hospital'... Seoul Has 'Clusters', Jeju Has 'Isolated Buildings'

Experts point out structural limitations that go beyond simply recruiting more doctors. The "Big 5" hospitals in Seoul introduce new technologies in real time through "bio clusters" where pharmaceutical companies, research institutes, and medical device firms are concentrated.

There is active clinical research for new drugs, and pharmaceutical companies even assign research nurses to clinics to support doctors' research and develop the latest treatment methods.

For severe patients who cling to even the faintest hope for survival, these new drugs and clinical trials are a dazzling beacon of hope, brighter than the crimson sun rising at dawn. This is why patients are willing to endure the cost and hardship of traveling to the metropolitan area.

In contrast, Jeju only has hospital buildings without the supporting industrial ecosystem. A medical professional commented, "The infrastructure gap is not narrowing, but simply putting a 'top-tier' label on the hospital and raising medical fees to Seoul levels is deceiving the residents," adding, "It is like putting a Mercedes badge on a car with a cultivator engine."