Dark clouds hanging over Korea’s medicine

Even if the government wins the lawsuit, there will be bigger problems ahead.

Choi Hyeon-chulThe author is an editorial writer of the JoongAng Ilbo. A fateful hour is drawing near. The Seoul High Court is expected to rule this week on the medical community’s request for an injunction to suspend the government’s increase of the medical school admissions quota. Whatever the outcome, the ramifications will be enormous.

The government claims that the planned annual increase of 2,000 medical students over the next five years was reached after meticulousl calculation. The government also claims that doctors opposed its plan without presenting an alternative.

The government’s argument is understandable, as some doctors left their patients while repeating their demand for a renegotiation from scratch. But the government also has not presented solid grounds to back its decision. It is willing to discuss the matter with the medical community if doctors present a more scientifically valid proposal.

This attitude is rooted in the government’s confidence that courts will dismiss any administrative suit raised by the medical community. After all, district courts have so far denied injunction requests filed by medical professors, trainee doctors and medical students. Consequently, the appeals court’s desire to examine the scientific veracity of the decision has the government in a panic.

First of all, the government didn’t properly take the minutes of meetings that were the basis of key decisions to increase the admissions quota. The Health Ministry submitted 47 documents and two references to the court on May 10. Of the four organizations that discussed the matter, minutes from the Health Care Policy Review Committee and the Expert Committee of Medical Professionals were submitted, but only the Medical Issues Consultation Council and the Medical School Admissions Quota Allocation Committee submitted summaries of their meetings and press releases.

The government explained that consultative bodies are not legally obligated to take meeting minutes, adding that they had agreed not to do so to allow for candid discussion. But such explanations are insufficient.

In contrast, the Korean Medical Association submitted to the court minutes of the meeting between the Japanese government and Japan’s medical community, showing a stark contrast to the Korean government’s complacent secrecy. Every single word of the discussions between Japan’s government and doctors on the medical school admissions quota over the past 40 years were recorded and published.

The government doesn’t seem to have any new evidence supporting its decision increase the admissions quota by 2,000, other than three reports that were already made public. Even the authors of those reports said their work could not serve grounds to support the increase.

Other data include media articles pointing to the shortage of doctors in rural areas and essential medicine, press releases, survey outcomes and statements from organizations in favor of the increase. Could such data be powerful enough to silence the doctors’ arguments that increasing the number of medical students will not necessarily resolve the shortage of doctors in essential medicine? If the high court issues an injunction, it will effectively cancel the government’s plan to increase the admissions quota this year. Medical reform will lost its momentum.

Of course, we cannot predict the court’s decision. The Seoul High Court said all administrative actions must be subject to judicial control. That is true in principle, but there is a catch. Judicial control is limited to cases where administrative action has specifically and directly infringed on rights. Without this limitation, every government decision should be authorized by a court before it is enforced.

Even if the government wins the lawsuit, there will be bigger problems ahead. It will be harder to convince doctors to return to their hospital now that the court hearing has exposed the government’s poor rationale and lack of preparations. If trainee doctors do not end their walkout by the end of May, hospitals cannot hire medical specialists next year. Meanwhile, this year’s freshmen and next year’s freshmen will have to take classes together for the next six years. Can our medical schools handle that? Medical professors are on the verge of resigning, not just suspending their services. Many hospitals will be forced to shut down. During this process, patients will suffer irreparable pain. Can the government tackle all of that?