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[Kim Seong-kon] Watching the medical school expansion dispute

By Korea Herald

Published : May 29, 2024 - 05:30

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Recently, the Seoul High Court overruled a petition by the medical community to block the government’s plan to drastically increase the enrolment quota at medical schools.

However, the controversy over medical school expansion will continue in South Korea because people think that it will bring not only medical reform but also ultimately the alteration of the Korean health care system.

Those who support the government’s policy criticize doctors for selfishly trying to protect their personal interests, without considering patients’ needs. Those who do not support the policy warn that it will benefit only a few mammoth hospitals and ultimately aims at privatizing the medical insurance system currently managed by the government at a deficit. If the opponents' claim is right, the new policy may be problematic, even though we need more doctors.

Presently, [the Korean health care system is a combination of socialism and capitalism; the government manages the medical insurance, while most hospitals are private. Therefore, Koreans can benefit from inexpensive health insurance and excellent medical services at the same time.

As a result, the South Korean medical insurance system is undisputedly one of the best in the world. That was why ex-US President Barack Obama wanted to import the Korean health care program to America when he implemented the Affordable Care Act to provide a government-sponsored inexpensive health insurance option to lower-middle class Americans, which was indispensable to them.

The problem with the Korean health care system is that it is so easy to see a doctor without an appointment, even for a common cold, and you only pay 3,000 won ($2.20) per visit. In many other countries, that is not possible. In the US, for example, you would not see a doctor with minor symptoms such as a cold or indigestion, and you must pay about $100 dollars, or 135,000 won, just to see them.

Such a uniquely Korean phenomenon hampers the opportunities for patients with urgent medical needs to see a doctor who is always busy treating not-so-urgent patients. In addition, doctors cannot allocate enough time for any one patient because so many patients are waiting. As a result, a Korean patient can typically expect to see his doctor for only a few minutes at a time. In the US, patients can see their doctor for half an hour to one hour at a time.

However, the American health insurance system has its own chronic problems. In the US, private companies sell various insurance policies to employers and individuals, and then negotiate the occurring medical expenses with hospitals and doctors. Therefore, in the US, medical expenses are astronomically high because hospitals tend to inflate them, expecting a drastic cut from insurance companies. If you do not have health insurance, therefore, you can find yourself in big trouble. In fact, even if you do have health insurance, problems still exist if it is not an expensive one with extensive coverage.

In the US, unlike Korea, dental care and vision are separate from health care, and thus you have to buy your own insurance policies for your teeth and eyes. Dental and vision treatments are costly in the US. For example, if you need a dental implant in the US, you could pay as much as $8,000, or 11 million won. Most dental insurance policies do not cover implants. In Korea, your insurance will cover up to two implants. With insurance, an implant will cost you about 500,000 won.

Some time ago, I heard that a group of Korean delegates from a previous government visited the US in order to learn how to implement the American medical care system in Korea. If the current government’s plan were similar, it would be a grave mistake and would end up being a disaster for the Korean people. Our government officials should ask ex-President Obama why he wanted to learn from the Korean health care system.

Of course, the US medical care system is all right when you have a decent job that provides you with good health care coverage. However, if you are self-employed and have to buy your own insurance policy, you could pay about $1,500 a month. In the US, the government provides retirees with free medical insurance through Medicare as long as they pay taxes for 10 years. The US government also takes care of the medical expenses for poorer people with Medicaid. Those things are what the Korean government should learn and import, not the privatization of health insurance.

South Korea will have to deal with the same problems the US has suffered, when and if it benchmarks the American medical insurance system. Among other things, the Korean people will have to buy much more expensive health insurance policies than the current one from private insurance companies.

We hope South Korea’s excellent health care system will remain untouched, no matter where the medical school expansion plan goes in the future.

Kim Seong-kon

Kim Seong-kon is a professor emeritus of English at Seoul National University and a visiting scholar at Dartmouth College. The views expressed here are the writer’s own. -- Ed.