[Editorial] Get to the specifics

More than 9,000 trainee doctors at hospitals across South Korea have offered to resign or have stopped working in protest of the government’s plan to increase the annual medical school freshman quota by 2,000. As a result, between 30 and 50 percent of surgeries have been postponed at the nation's five largest hospitals.

The Ministry of Health and Welfare has issued orders for over 6,000 interns and residents to return to work, and plans to take administrative action such as revoking the medical licenses of those who did not comply with the order.

South Koreans are in a way inured to strikes by doctors, and the government appears more resolute than ever.

The Ministry of Justice, the Ministry of Interior and Safety, the prosecution and the police said in a joint press briefing Wednesday that they will arrest those leading the illegal collective action, and take stern measures against those obstructing medical treatment or doctors' return to work. Interns and residents who refuse to resume service can be indicted for trial, they said.

President Yoon Suk Yeol said trainee doctors and med school students must not hold people’s lives and health hostage.

“Along with national security and public safety, protecting the people’s lives and safety is the reason a state exists and the most basic Constitutional responsibility of the government,” Yoon said in a Cabinet meeting on Tuesday.

“In that sense, the state must efficiently manage medical resources to protect the people’s lives and health.”

Stressing that the planned increase of the medical school admission quota is the bare minimum, Yoon also said that while raising the quota alone obviously doesn’t resolve the collapse of essential health care in provincial regions, it is a prerequisite for relieving the problem.

About claims that the rise in medical student intake will lead to degrading quality of medical education, Yoon noted the medical school freshmen quota at Seoul National University is currently 135, but was 260 in 1983, and those who got their education as physicians 40 years ago were not in the least bit lagging in their competence. In fact, they were the ones who raised the country’s health care to the world’s top level, he said, adding that the government will invest and assist where necessary in medical education.

The government has said it will spend over 10 trillion won by 2028 to resuscitate areas of essential health care such as pediatrics, emergency medicine, general surgery, cardiothoracic surgery and obstetrics. The plan includes revamping the national health insurance system to raise the prices of treatments in those specialties as an increasing share of medical school graduates chase more lucrative specialties or choose not to be specialists at all, to run aesthetics or pain management clinics as general practitioners.

Doctors’ groups such as the Korea Medical Association and the Korean Intern Resident Association argue that the number 2,000 is way too big, and question the efficacy of the government’s plans to raise compensation for doctors in essential health care such as pediatrics. Increasing the price of pediatricians' consultations is crucial, but the health ministry’s plan is centered on that of in-patient treatment, and therefore won’t help resolve the shortage of pediatricians, they say.

They are also against the government’s policy to restrict simultaneously offering health care services that are covered by the national health insurance and those that are not. The ministry has said the restrictions will apply to only the non-essential non-benefit services, but doctors say this will significantly reduce their profits, and degrade the quality of service to patients.

A publicity figure of the KMA said it would be “theoretically right” for the government to first raise the prices of health care under the national health insurance system to "OECD average level," and then say “non-benefit treatments are immoral.”

The ministry must continue talks with physicians’ groups to work out the specifics of its policies, but the doctors should also keep in mind that walking out on patients cannot be the ultimate solution to their problems. The ministry should explain to them in greater detail how the 10 trillion won in taxpayer money will be spent to achieve the greater cause of having more physicians in lifesaving specialties and in provincial regions.