🚨 Medical-Government Conflict: Disputes Between Medical Community and Government and Changes in Healthcare System

Today Korean Social News | 2025.05.18

📌 Medical-Government Conflict Continues Despite Medical School Quota Freeze…Concerns Over Long-term Medical Gaps

💬 Although the government decided to keep medical school quotas at current levels, the medical-government conflict remains unresolved. Only 25.9% of medical students have returned, and 8,300 students have been held back. This is expected to cause a "tripling" phenomenon next year, where up to 6,100 students will attend first-year classes at the same time. In medical settings, there are cases where emergency patient transfers are delayed due to lack of residents. The government spent 3.5 trillion won on emergency medical systems and training hospital support, but the timing of health insurance financial deficit is expected to move up.

Summary

• Medical-government conflict means policy disputes between the medical community and government.
• Medical school quota expansion, medical fees, and healthcare reforms are major issues.
• Long-term conflicts directly affect medical service quality and public health.

1️⃣ Definition

Medical-government conflict refers to conflicts between the medical community and the government. Simply put, it means situations where doctors and the government take different positions and clash over medical policies.

These conflicts mainly occur around policies like medical school quotas, medical fees, healthcare reforms, and public healthcare expansion, and they directly affect medical service delivery.

💡 Why is it important?

• It directly affects public health and medical accessibility.
• It's an important factor that determines the sustainability and development direction of the healthcare system.
• It affects doctors' working conditions and morale, which impacts medical quality.
• It influences health insurance finances and medical cost burden.

2️⃣ Main Causes and Issues of Medical-Government Conflict

📕 Major Conflict Factors

• Medical school quota expansion is the biggest issue. The conflict over medical school quotas includes:

  • The government argues that the number of doctors must be increased to prepare for aging and increased medical demand.
  • The medical community argues that reckless increase in doctors could lead to decreased medical quality and excessive treatment.
  • The government's position that quota increase is needed to solve regional medical imbalances and secure essential medical personnel conflicts with the medical community's concerns about lack of educational infrastructure and medical market saturation.
  • The government's plan to increase medical school quotas from the existing 3,058 to 5,058 (adding 2,000) starting in 2024 was cancelled due to medical community opposition.

• Medical fees and health insurance policies are also conflict factors. Economic conflicts include:

  • Medical professionals argue that medical fee increases are insufficient compared to rising operating costs and labor costs.
  • The government is cautious about rapid fee increases, concerned about health insurance financial health and increased medical cost burden.
  • There are growing calls for realistic pricing and improved training conditions in essential medical fields (pediatrics, obstetrics, emergency medicine, etc.).
  • There are also differences of opinion between the medical community and government regarding expansion of non-covered items to covered benefits.

• There are controversies over public healthcare expansion and medical privatization. Healthcare system direction conflicts include:

  • The government is pushing for public healthcare expansion through establishing new public medical centers and strengthening essential medicine.
  • Private medical sectors worry that public healthcare expansion could negatively affect private medical institutions' management.
  • There are also disagreements about introducing new medical technologies like telemedicine, medical data utilization, and medical device regulations.
  • There are also differences between the medical community and government regarding expanded use of PAs (physician assistants).

📕 Ways Conflicts Are Expressed and Their Impact

• The medical community expresses its positions in various ways. Main response methods include:

  • Medical strikes or treatment refusal: They express opinions through collective clinic closures and indefinite strikes.
  • Political lobbying: They demand policy changes through the National Assembly or political parties.
  • Media activities and public opinion creation: They inform the public of their positions through press conferences and statements.
  • Legal responses: They attempt resolution through the judiciary via administrative lawsuits or constitutional appeals.

• Long-term conflicts cause serious social impacts. Main impacts include:

  • Medical service interruptions delay emergency patient treatment and postpone surgeries.
  • Disruption of training for residents and medical students affects future medical personnel development.
  • Citizens' medical accessibility decreases and medical cost burden may increase.
  • It burdens health insurance finances and affects national financial health.
  • Trust between the medical community and government is severely damaged, making future policy cooperation difficult.

Major Problems of Medical-Government Conflict

1. Lack of communication: Medical field voices are not sufficiently reflected in policy decision processes
2. Conflicting interests: Medical community's economic interests clash with government's budget-saving goals
3. Politicization: Medical policies are swayed by political logic, weakening professionalism
4. Public harm: Citizens who need medical services are harmed during conflicts
5. Lack of long-term perspective: Getting caught up in short-term interests and missing long-term healthcare system development direction

3️⃣ Recent Medical-Government Conflict Status and Response

✅ 2024-2025 Medical-Government Conflict Status

• Conflict over medical school quota expansion reached its peak. Recent conflict progress includes:

  • The conflict began in February 2024 when the government announced a plan to increase medical school quotas by 2,000.
  • The medical community responded with full strikes, and residents submitted resignation letters en masse.
  • Medical students also joined by refusing to take national exams, causing major disruption to the medical personnel training system.
  • In 2025, the government decided to freeze medical school quotas at existing levels, but conflicts continue.
  • Only 25.9% of medical students returned, resulting in 8,300 students being held back.

• Medical field gaps and aftereffects are serious. Real impacts of the conflict include:

  • Due to lack of residents, major hospitals are reducing emergency room operations or postponing surgeries.
  • Emergency patient transfer times are getting longer and treating severe patients is becoming difficult.
  • Next year, a "tripling" phenomenon is expected where up to 6,100 students will attend first-year medical school classes simultaneously.
  • Medical staff workload has increased, raising concerns about burnout and low morale.
  • Personnel shortages in essential medical fields are becoming more severe.

✅ Government Response and Support Policies

• The government is pursuing measures to minimize medical gaps. Main countermeasures include:

  • Operating emergency medical systems to prioritize emergency care and severe patient treatment.
  • Expanding the role of public medical institutions and strengthening cooperation with private hospitals.
  • Expanding the work scope of nurses and PAs (physician assistants) to fill medical gaps.
  • Accelerating introduction of telemedicine and digital healthcare to improve medical accessibility.

• Huge budgets have been invested but financial burden is growing. Financial responses and limitations include:

  • The government invested 3.5 trillion won in training hospital support and emergency medical system operations.
  • Additional budgets were allocated for improving medical staff treatment and raising essential medical fees.
  • However, the timing of health insurance financial deficit is expected to move up.
  • Pressure for insurance premium increases due to rising medical costs is growing, raising concerns about increased public burden.
  • The next government faces urgent tasks of restoring trust with the medical community and developing sustainable solutions.

4️⃣ Related Terms Explanation

🔎 Resident

• A resident is a doctor in training to become a specialist after graduating from medical school.
• A resident refers to a doctor who has graduated from medical school and obtained a medical license, and is gaining clinical experience at a training hospital to become a specialist in a specific medical field. Generally, they must go through a 4-year training process to obtain specialist qualifications.
• Residents perform various medical tasks including patient care, surgical participation, and medical research under supervision of attending physicians while acquiring professional knowledge and skills. Residents play a very important role in hospital operations, and especially for large hospitals, normal medical care is difficult without residents.
• Residents work under high intensity with relatively low pay, and recently demands for improved working conditions and better treatment have been growing. In this medical-government conflict, mass resignations of residents became a key issue.

🔎 Essential Medical Care

• Essential medical care refers to medical services that are essential for public life and health but are undersupplied due to low profitability.
• Essential medical care refers to medical services related to trauma, emergency, severe cases, pediatrics, childbirth, etc. that are directly connected to people's lives and health but are undersupplied because they are less profitable or avoided. This is an area where sufficient supply is difficult based on market logic alone and requires government policy intervention.
• Major fields of essential medical care include emergency medicine, critical care medicine, pediatrics, obstetrics and gynecology, thoracic surgery, and neurosurgery. These departments tend to be avoided by many doctors because they have high medical accident risks, intensive work schedules, and relatively low profitability.
• The government is pursuing policies such as expanding resident quotas, realistic pricing, improving working conditions, and enhancing medical staff treatment to expand essential medical care. It is also simultaneously expanding essential medical care provision through public medical institutions and supporting private medical institutions.

🔎 Medical Fees

• Medical fees refer to prices for medical services and mean treatment costs paid to medical institutions by health insurance.
• Medical fees are prices for medical services. In Korea, the government sets fees for each medical procedure under the National Health Insurance system. When patients receive treatment at hospitals, the Health Insurance Corporation pays medical institutions according to set fees.
• Medical fees are decided annually by the Health Insurance Policy Review Committee where the medical community, civic groups, and government negotiate the rate of increase together. Fees directly affect medical institutions' management and medical staff income, while also greatly affecting health insurance finances and public medical cost burden.
• Recently, medical community complaints are growing that fee increase rates are low compared to rapid labor cost and operating cost increases. Particularly, demands for realistic pricing in essential medical fields and proper value reflection of medical procedures continue, making this one of the main causes of medical-government conflict.

5️⃣ Frequently Asked Questions (FAQ)

Q: What impact does medical-government conflict have on ordinary citizens?

A: Medical-government conflict directly affects citizens' daily medical use. The most immediate impact is decreased medical service accessibility. When hospital operations are reduced due to medical strikes or resident resignations, appointment delays, surgery postponements, and increased emergency room waiting times occur. This is especially serious for severe or emergency patients as it can be life-threatening. Economically, medical cost burden may increase. Government support for the medical community to resolve conflicts may lead to health insurance premium increases, and additional costs may occur when using private medical institutions for alternative treatment. Also, increased workload for medical staff can lead to decreased medical service quality, potentially affecting overall medical standards in the long term. Therefore, medical-government conflict is not simply a problem between the medical community and government, but an important social issue directly connected to all citizens' health.

Q: What efforts are needed to resolve medical-government conflict?

A: Fundamental resolution of medical-government conflict requires multi-faceted approaches. Most importantly, communication channels must be secured. Regular and systematic dialogue bodies should be operated so that medical field voices can be sufficiently reflected in medical policy decision processes. Rather than unilateral government policy announcements, it's important to establish policies through sufficient prior consultation with the medical community. Second, mutual understanding and trust building are needed. The government should respect the medical community's professionalism and field experience, while the medical community should recognize social responsibility for public welfare and public health. Third, gradual and progressive policy implementation is needed. Rather than rapid changes, it's advisable to implement policies with sufficient preparation periods while helping the medical community adapt. Finally, citizen participation and monitoring are important. It's necessary to minimize the impact of medical-government conflicts on citizens and ensure that citizen voices are reflected in the conflict resolution process.

Q: How do other countries resolve medical-government conflicts?

A: Foreign countries have various systems and practices for resolving medical-government conflicts. In Germany's case, they have a governance system where the medical community, insurers, and patient representatives decide medical policies together through the 'Federal Joint Committee (Gemeinsamer Bundesausschuss)'. All major medical policies are decided through consensus of this committee, preventing conflicts in advance. France regularly concludes comprehensive agreements on fees, working conditions, and medical quality through 'social conventions' between medical professionals and the government. These conventions have legal binding force and sanctions follow violations. The Netherlands actively uses a 'stakeholder participation model' in medical policy decision processes, collecting opinions from all related parties from the early stages of policy development. They also have a system for continuously improving policies through policy evaluation and feedback. The common point of these examples is that they have institutionalized consultation systems, social agreements based on mutual trust, and continuous communication and evaluation systems. Korea also needs to establish institutional mechanisms to prevent and resolve medical-government conflicts by referring to these experiences.