Due to the conflict between the government and medical community, some patients experienced inconvenience.
/Illustrated by Lee Su-yeon
Recently, a lot of people have put forward various opinions about the medical communities’ strikes opposing the policies that the Ministry of Health and Welfare (MOHW) announced. The policies are about the development of health and medical services. The four main issues of the conflict have been controversial for a long time. The conflict was intensified as the government, which felt the need to increase the number of doctors during the COVID-19 situation, publicized the policy of increasing the number of doctors in May.
How did the conflict develop?
In June, as the MOHW progressed with the discussion about a pilot project for including oriental medicine in health insurance, the conflict with the Korean Medical Association (KMA) increased. In July, the KMA announced that they would go on a general strike unless the government discusses the policy with experts. However, the government announced policies about establishing the public medical university and including oriental medicine in health insurance, which led to the doctors’ strikes in August. On September 4th, the KMA and the MOHW fortunately came to an agreement on the development of health and medical services and overcoming COVID-19. Meanwhile, the residents and medical students protested the agreement for being too hasty. The medical students even refused to take the National Examination for Medical Practitioners and boycotted classes. Later, on September 14th, medical students stopped taking collective action as the “permanent watchdog for healthcare policy” was launched, which was proposed as a condition for the suspension of the boycott. The system will be operated by the Korean Medical Student Association (KMSA) and the Medical Professors Association of Korea with the aim of monitoring the implementation of the parliamentary agreement and solving medical problems such as regional medical imbalances and the avoidance of specific departments. Yu, a student of Dongguk University, said about the series of events, “It was sad to see patients suffering from the conflict occured from the lack of conversation between the government and the medical communities. It seemed that they both lacked effort to understand each other for the problem solving.”
Four main issues caused this conlict
-Increasing the medical school quota & Establishing a public medical school
On July 23rd, the MOHW announced that they were going ahead with the public medical university plan. It is intended to solve the problem of doctors’ concentration in metropolitan areas and the avoidance of specific departments by reinforcing some and relocating others. The main contents are as follows: For 10 years from 2022, the current medical school quota will be increased by up to 400 to train 50 experts in special fields and 50 medical scientists. The remaining 300 students will be decided through a “special screening for local doctors” and forced to work at local hospitals for 10 years after obtaining a doctor’s license, and receive scholarships in return. If they violate the law, they must return their scholarships and will forfeit their doctor’s licenses.
The KMA said over the policy (the ten-year principle) that after one year of internship and four years of residency, the doctors will open new hospitals in other regions after completing the remaining five years of mandatory local medical service. Also, it should be considered whether the public universities are in a condition where sufficient education can be provided. Instead of hastily increasing the number of doctors and promoting the establishment of public universities, the government can solve the problem by improving the treatment of doctors in vulnerable areas or essential medical departments, and relocating doctors.
Similar to what happened in Korea, Germany has recently decided to increase the medical school quota. However, the difference between German and Korean is that the German government clearly suggested why they must increase the quota up to 5,000 and reached an agreement by communicating with medical workers for a long time.
Baek, a student of Ewha Womans University, said, “I can understand that the government put forward the policies as they felt the need of increasing the number of doctors during the COVID-19 situation. However, they should have solved the problem by finding agreements first as Germany did.”
- Including oriental medical treatment in health insurance
The government announced that it will carry out a pilot project of including the medical treatment of menstrual pain, cerebrovascular disease (over 65 years old) and facial nerve paralysis in health insurance. The project will be carried out at oriental medical clinics that meet the conditions such as using standard herbal medicine and disclosing prescription details. Also, a system establishing oriental medicine standards will be made.
The KMA said that the safety and effectiveness of oriental medicine are not clear yet. Also, it is not too late to start the project after conducting sufficient clinical trials with the same standard as the western medicine.
However, the Association of Korean Medicine (AKOM) supported the policy by claiming that the project is carried out with the request of the public. The public is visiting oriental medical institutions to treat diseases, and 94 percent of outpatients and 90 percent of hospitalized patients are satisfied, indicating a high willingness for the use of service. Also, medicinal herb is carefully managed to meet the standards of the Ministry of Food and Drug Safety (MFDS) and there are studies and statistics that prove oriental medicine is effective in menstrual pain, facial paralysis, and the aftereffects of cerebrovascular diseases.
- Expansion of non-face-to-face medical care
Telemedicine is a medical service that allows patients to receive medical treatment through remote medical equipment without visiting hospitals. The nature of non-face-to-face medical care is similar to telemedicine. According to experts, the government might used the word “non-face-to-face” rather than “telemedicine” to emphasize that the situation has changed as untact (meaning uncontacted) consumption became familiar due to the COVID-19.
The KMA criticized that because of the restricted communication, safety and effectiveness are not clear. Also, patients will be concentrated in the university hospitals’ online medical care services, which will lead local hospitals in small or medium-sized cities and rural areas to disappear at the end. In other words, they expressed concerns that the health care delivery system will collapse if the non-face-to-face medical care begins without discussing anticipated problems.
The MOHW and the KMA reached an agreement on September 4th.
/Extracted from the MOHW
Both the related parties are criticized by people
The most controversial issue was the selection of students for public medical university. The MOHW posted a fact-checking card news material regarding the controversy over the student selection procedure. It said that “A neutral city and province recommendation committee will be formed with experts and officials from civil society organizations. Also, the committee will objectively and reasonably recommend two to three times the number of people assigned to cities and provinces based on the screening criterion by the government.” However, it caused more controversies and a public petition has also been filed, calling for a thorough investigation of the “public medical university gate.” As the card news material became an issue again, the MOHW posted an explanation. It said, “The participation of officials from civil society organizations, mentioned in the card news, is merely an example of the need to listen to the opinions of those engaged in various fields, considering the specificity of compulsory public health service (the ten-year principle). Also, nothing has been decided on the student selection procedure and it will be discussed at the National Assembly in the future.” Regarding this issue, Lee , a student of Dongguk University, said that “Clear standards should be established for medical student selection procedures so that the quality of medical care does not deteriorate.”
Yu criticized the series of incidents, saying, “The government should improve the existing problems of the medical system rather than adopting a new system such as publishment of public medical university or non-face-to-face medical care. It would be great if the goal of the government, which is increasing the number of doctors and relocating doctors to areas in need of medical service, is met. However, the goal may not be easily achieved due to the loophole of making doctors mandatorily work at local hospitals.” She made a point about the solution, saying, “I think identifying and solving current problems of medical system are the fundamental solution, which would help the government and medical community reach an agreement without severe friction.” She also added, “It was shocking that doctors who are dealing with people’s health went on a strike while causing some possible damages to patients. Of course, a strike is the strongest means to assert one’s opinion, but I think they should not have made damage to patients.”
Baek also made a point, saying, “I think the medical community should have acted more carefully. However, there is also the government’s fault for threatening the health of the people in that they pushed ahead with the policy without reaching agreements.”
There might have been no strike by the medical community if the government had discussions with the related parties (the medical community) to come up with reasonable measures before unilaterally announcing policies after government-ruling party consultations. The government must discuss thoroughly with the experts before making policies that are closely related to people’s daily lives. Meanwhile, the medical community should do their jobs while putting the health and convenience of the people first. Also, they should keep monitoring whether the government’s policies are in the right direction. Meanwhile, Lee emphasized, “It is important that we, the public, must look into the conflict that is closely related to our lives, such as recent conflict between the government and the medical community, rather than being influenced by media framing.”
Lee Su-yeon firstname.lastname@example.org
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