[Series] The 'Uncomfortable Bill' of Jeju’s Top-Tier Hospital Seen by a Cancer Patient Journalist (Part 2)

[Part 2] "Medical Fees Increased by 20%"... Controversy Over 'Deficit-Covering Bill'
'Medical Fee Hike' First Revealed by Hospital Director... 'Surprise Bill' Without Residents' Consent
"Will Higher Costs Mean Better Care?"... Only Vague Promises, No Concrete Roadmap

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, there are growing concerns that it may only result in a 'cost explosion' for local residents. Over the course of two articles, a journalist who is also a cancer patient shares firsthand experiences from receiving treatment over the past two years, shedding light on the realities of the local healthcare system.

While government officials and hospital administrators have acknowledged the inevitability of critically ill patients seeking care elsewhere, this series examines the structural contradiction in which medical fees rise without the necessary infrastructure or essential medical personnel. In particular, it highlights the absence of psychological comfort and human rights for critically ill patients in the current system, beyond just medical technology, and notes the strong public sentiment that securing genuine medical capabilities for those who cannot travel to Seoul should take precedence over upgrading the hospital merely to offset deficits.

"Busy Since Dawn"... Patients Flocking Nationwide

The waiting room of a major tertiary hospital in Seoul (one of the 'Big 5') is packed with patients and their guardians from early morning, leaving no space to move. Many of these patients have traveled from all over the country, including Jeju, by KTX and airplane for medical treatment. This crowding, where patients endure time and costs to come to Seoul, starkly reveals the current state of regional medical imbalance and the concentration of healthcare resources in the metropolitan area.

Photo by Park Changwon.

As the designation of a top-tier general hospital in Jeju becomes more likely, the greatest shock facing local residents is the 'cost.' However, there has been no social consensus or public discussion regarding this financial burden. While the provincial government and hospitals have been touting the slogan of 'medical independence,' residents are now faced with a 20% increase in medical bills without any clear explanation.

'Cost Explosion' First Revealed by Hospital Director's Statement... "Why Wasn't This Disclosed Earlier?"

The fact that medical fees would increase with the designation of a top-tier general hospital was specifically mentioned for the first time last week during a press conference held by Choi Gukmyung, Director of Jeju National University Hospital.

Until now, Jeju provincial officials and politicians have promoted the designation as "the wish of the residents," but the reality that residents would have to bear a '60% increase in outpatient co-payment' and '100% of the basic consultation fee' was kept hidden.

Within the community, criticism has emerged that "they only talked about better service, but never mentioned that we would have to pay more," and that this is "essentially a surprise price hike notification."

In the process of overhauling the public healthcare system, there was no procedure to ask the most important consumers-the residents-about their 'willingness to pay' or 'consent.'

"Let's Skip Lunch and Do It Now"... Why a Stage 4 Cancer Patient Fled

Even more serious than the cost is the 'value for money,' namely the quality and attitude of medical services. The journalist's personal experience clearly exposes the lack of 'patient-centered' care in Jeju's medical system.

Two years ago, after undergoing a CT scan at Jeju National University Hospital, the journalist entered the consultation room to hear the results. A young doctor, looking at the monitor, casually announced, "You have nasopharyngeal cancer." Before the patient could even process this devastating diagnosis, the doctor abruptly suggested a tissue biopsy.

The doctor said, "I'll postpone my lunch break, so let's do it right next door. Since the nasopharynx is inside the nose, we'll take a tissue sample right away, and for the metastasis in your neck, we'll do an invasive needle biopsy immediately."

There was no time to recover from the shock of the cancer diagnosis, nor was there a sufficient explanation. It felt as if the patient was being treated like a machine part, with the attitude of "I'll give up my lunch break, so let's get this over with quickly."

At that moment, the journalist felt not treatment, but 'coercion.' Overwhelmed by fear and a primal sense of crisis-"I might die here"-the journalist fled the hospital, leaving their spouse behind.

From there, the journalist went straight to one of Seoul's major tertiary hospitals, one of the 'Big 5.' The response there was completely different. The medical staff explained that "nasopharyngeal cancer is a rare cancer deep inside the nose, so a tissue biopsy is essentially surgery and must be approached cautiously," and prepared for surgery under general anesthesia. Before admission for the procedure, a dedicated nurse thoroughly explained the treatment process and preparations.

Subsequently, the journalist was diagnosed with stage 4 cancer-a critical condition with no guarantee of survival. Had the journalist undergone a painful, unprepared, and anesthesia-free biopsy in Jeju, the resulting trauma might have shattered even the will to fight the disease.

A hospital that tried to "take care of" a stage 4 cancer patient during a lunch break-can simply upgrading its status win the residents' trust when such outdated systems and mindsets remain unchanged? There is strong doubt.

What matters more than a signboard is 'trust' and 'complete recovery.' The path that a top-tier general hospital in Jeju must take is clear. Residents choosing Jeju hospitals over flights to Seoul should be based on 'trust,' not 'coercion.' We hope that the image of a cancer patient peacefully smiling while receiving care from Jeju medical staff becomes not just a simple imagination but the reality of Jeju's tomorrow. (AI generated image)

"Respect Those Who Choose Seoul, and 'Select and Focus' on Areas Where Jeju Excels"

The hospital claims that with the top-tier general hospital designation, it aims to "treat all critically ill patients on the island." However, experts point out that this is little more than an empty promise. As the journalist's experience shows, it is impossible to match Seoul's vast medical system and human resources in a short period of time.

It is time to be honest. As the authorities have acknowledged, for ultra-rare diseases, severe illnesses requiring long-term treatment, and cases where patients are able to travel for care, their choices must be respected. Forcing them to stay will not solve the problem.

Instead, given Jeju's geographic challenges as an island where emergency transfers are difficult, efforts should focus on "diseases where missing the golden hour in Jeju means death." This means 'selecting and focusing' on essential medical fields such as emergency brain and heart surgery, severe trauma, and high-risk pregnancies-areas where lives are lost because there is no time to reach Seoul. In these fields, Jeju must be even better equipped than Seoul.

Once again, there must be an honest process of informing Jeju residents about the increased medical costs resulting from the top-tier hospital designation and gathering their input.

The designation of a top-tier general hospital should be a means, not an end. Without a clear roadmap-one that distinguishes which patients should be sent to Seoul and which must be saved in Jeju-this designation will remain nothing more than a 'cruel hope' and an 'expensive bill' for residents, rather than a true solution.