The Moon Jae-in Government’s War Against Young Medical Doctors in South Korea…the Cuba Model?

2020-9-9, Tara O

On August 7, 2020, young doctors (residents) went on strike denouncing the government’s policy in South Korea.  In solidarity, 2,782 of 3,036 of senior medical students refused to register for medical license exams, according to the report posted by the Korean Medical Association on its Facebook account.  On August 14, Korean Medical Student Association joined the residents in a strike in Yeoido, where the National Assembly is located.  As of August 28, 2020, there have been six strikes.  Meanwhile, South Korean president Moon Jae-in criticized the strikes and called the young doctors “deserters” and ordered them to be “firmly dealt with.” The Ministry of Health and Welfare threatened the doctors with 3 years imprisonment/30 million won (~$25,000) fine as well as license revocation.  

In early 2019, the Moon Jae-in administration took steps toward socialism and away from capitalism, when it tried to control kindergartens.  At that time, it was predicted that the Moon government would also intervene in other private sectors, such as the healthcare sector, most of which is private, as it opened the door for serious government infringement upon private enterprises.  It appears the effort to control and nationalize the healthcare sector has begun, including controlling current doctors by designating them as “health care resources” under the government, by producing 4,000 new government-controlled doctors over 10 years starting 2022, and by controlling the medical school teaching sector that produces future generations of doctors.  A heightened chance of corruption is added by its admissions process, which involves nominations, rather than superior test scores, for selecting candidates  for the newly planned government medical schools.

Do South Korean’s have great access to healthcare?  Yes.

The government implied there are three problems with the medical system in South Korea:  a shortage of doctors, not enough doctors in rural areas, and not enough doctors in less desired fields.  Are these really problems?  

South Koreans enjoy a high-level of access to doctors and high quality care.  On average, South Koreans see doctors 16.6 times per year, whereas the OECD average is 6.8 times per year. (1:40)  In certain OECD countries, the percentage of adults who were able to make the same day or the next day appointment when they needed care in 2016 was:

• Canada:  43%
• Norway:  43%
• Sweden:  49%
• The U.S:  51%
• Germany:  53%
• France:  56%
• UK:  57%
• Switzerland:  57%
• New Zealand: 76%
• The Netherlands:  77%

For South Korea, the percentage of those who needed the same day appointment (so not even the next day) and got them was 99.2% in 2019. (2:58)    Most Koreans do not even make appointments when they go see their doctors, and even then, the average waiting time is 19.9 minutes (3:30).  Often, South Koreans do not have to wait in emergency rooms; rather the doctors wait for the patients. (5:14)  The ease of access to specialty doctors is the same. (5:18)  By comparison, in the U.S., the waiting time in the emergency room varies, but ranged from 100 minutes to 350 minutes.  In Quebec, Canada, the likelihood of not being able to see an ER doctor within 4 hours is 51.2%, and Canadians must wait 4 weeks on average to see a specialized doctor. (4:29)  South Koreans do not have to wait long for elective surgeries either.  For cataract surgeries, for instance, there is no wait time.  The U.S., Canada, and many other OECD countries have more doctors per 1,000, yet South Koreans have ready access to doctors and see doctors more often.

South Korea has one of the highest numbers of doctors per given geographic area.  South Korea has 11.4 doctors per 10 square km, placing South Korea as number 3 on the list of OECD countries, and higher than the OECD average of 4.7 doctors. (p. 114)

A doctor (Dr. Shin) who has his own Youtube channel, refuted the claim that there’s a shortage of doctors in South Korea.  (1:21)  He explained that for most people living in cities, there are numerous primary doctors’ offices within 15 minutes of walking distance from many residences, and if they want to be treated at major university hospitals, most people can be seen even without appointments at many of these university hospitals.  (1:22)  This description of excellent access to doctors in South Korea is also echoed by another YouTuber below, who pointed out similar reasons.

Thus, it is not the numbers per 1,000 that is important, but whether the patients can access the doctors that matter.  The insistence that raising the number of medical students increases health care access is a moot point.  Besides, the growth rate of the supply of doctors in South Korea is 3.1%, which is already the highest among OECD countries. (3:22)

During the height of the Coronavirus pandemic, South Korea’s success in managing the pandemic was and still is due to its excellent health care system and dedicated medical professionals, in spite of the Moon government’s refusal to ban entry from China, from where more than 20,000 visitors a day entered South Korea, while the Moon administration sent millions of masks, other PPE (personal protective equipment), and millions of dollars to China.  Thus, the doctors, nurses, and other healthcare professionals were the ones who had to deal with the consequence of the Moon government’s actions of importing Coronavirus from China and creating mask shortages.  The Moon government’s policy was to provide free medical care to COVID-19 positive patients from China, so there was an incentive for Coronavirus-infected Chinese to visit Korea as well, which hampered efforts at prevention and placed an even greater burden on the doctors, nurses, and other health care professionals, as well as on the taxpayers.

Many doctors and nurses, who volunteered to go to Daegu during the height of the pandemic still have not been compensated by the government as promised.  Often, they worked long hours in difficult conditions.  Some who returned even lost their medical offices because it was such a financial loss.

Dr. Shin emphasized that the doctors do not leave the patients.  During the height of the Coronavirus pandemic, the ones who stayed with the patients were the doctors, unlike politicians, who took pictures and left. (10:15)  

The media, including international media, often praised the Moon administration for its “successful handling” of the SARS-CoV-2 pandemic, but it was an undeserved praise; the real praise should go to the hard working and dedicated doctors, nurses, and other healthcare professionals and the health care crisis response system that was already in place from the lessons learned from MERS and SARS crises prior to the Moon administration.

Are there problems and if so, what are the solutions?

South Korea has national medical insurance that was created under president Park Chung-hee in 1977.  Various changes have been made to the system over time.  The key problem is the actual cost to the hospital exceeding what the government, as the national health insurer, reimburses.  Since the Moon administration began, it included numerous other surgeries and procedures that were not previously  covered or not covered fully, but the problem was that the insurer (the government) did not pay for their costs.

Under the so-called “Moon Jae-in Care,” the government reimburses only about 70% of the cost of a surgery.  When a patient receives a surgery, the costs include personnel (the surgeon, anesthesiologist, nurses, and other health care professionals involved in making the operation possible), medical equipment and supplies, medication, rent, utilities, and other expenses.  If the surgery costs $10,000, the government pays the hospital $7,000, leaving the hospital to figure out how to pay for the $3,000 just to break even.  Thus, the more surgeries the hospital performs, the greater the losses.  The hospital management and doctors have been known to “donate” their salaries to make up the difference or to transfer money earned from funerals and parking to make up for the losses.  The hospitals also save where they can.  It is not a sustainable system.  

The payments for these specialties are limited due to the government setting fees.  Thus, a brain surgeon or a heart surgeon, who are highly respected and well-compensated in the U.S., face the opposite in South Korea.  The real reason for not enough doctors going into these “vital” fields–General surgery, specialized surgery (cardio-thoracic surgery, etc.), internal medicine, pediatrics, OB/GYN–is because of the low fees for their service, which is set by the government, the insurer. (2:57)  Due to the low fees, the hospitals do not want to hire more, so there are less jobs available in these fields.  (5:05)  Furthermore, the low fees also translate to relatively lower pay for the doctors in these specialties. (9:30)  Thus, many of these physicians, who are already trained in their specialty, give up their specialty and retrain into other fields. (5:05)  So it is not that there are shortages in these vital fields, but the already trained and licensed doctors in these specialties cannot get jobs, because the hospitals are not hiring, and the hospitals are not hiring because of the reduced levels of reimbursement that the government, as the insurer, pays them. (5:38) 

There are other disincentives, including always being on call to receive emergency patients and much higher chances of malpractice lawsuits, for which they are personally liable, since they deal with patients whose lives are at a higher risk of loss. (9:30)  What added to this concern was the jailing of three doctors on October 24, 2018 for incorrectly diagnosing an 8-year old patient with a stomach ache, who later died of low blood volume shock caused by a diaphragmatic hernia and hemothorax.  The pediatric department chief received 1.5 years imprisonment, while the emergency medicine chief and the family medicine resident received 1 year imprisonment each.  

A pediatrician said that diaphragmatic hernia is extremely rare, especially for an 8-year old, and a cardiothoracic surgeon said although he has performed surgeries for diaphragmatic hernia, the patients are usually adults who have been in car accidents or experienced other serious injuries, and hardly ever children.  Emergency medicine doctors described their work environment as one that makes ER doctors anxious, “It’s not just an individual matter. Emergency medicine resident doctors say they can’t do emergency room treatment.  How do you work if you will be held responsible for diagnosis? This is on top of doctors already being assaulted in the emergency room.”  And added that the emergency room is where they quickly take emergency measures and refer them to relevant specialties, and said the young patient “had no fever and no breathing problems. All the vital signs were normal.”

Without addressing the relatively lower pay (due to low fees set by the government), the danger (of lawsuits and imprisonment) of the work environment, and the ER schedule for the “vital” specialists, especially the first two points, the problem will not be resolved.

Another issue the Moon administration labeled as a problem is the availability of doctors, especially specialty doctors, in rural areas, which is not really a problem, because the locals have ready access to doctors already, and if they require specialty care, then specialized doctors are within a 1-2 hour distance.

Dr. Shin, who has first-hand knowledge and experience practicing medicine in rural areas for 37 months, explains on his YouTube channel about the health there.  Administratively, below the provinces are “goon” (counties), and under goon are “eup” (districts), and under eup are “myeon” (villages).  Dr. Shin said at the “eup” level, there are a number of physicians and also public clinics.  In a larger “myeon,” there is a clinic and even in a smaller myeon, there is a community health center branch, where public health physicians work for 37 months.  Thus the locals have access to a doctor even in villages. (1:47)  There usually is no waiting time, and if on occasion, there is a wait, it may be about 5 minutes. (2:12)  For those older than 65 years, the price of medical care is free, and for those under 65 years, the price is only ₩500 (42¢), which is less than the price of a pack of gum. (2:25)  He concluded that there is nowhere in the world where the access to medical care is so great–close proximity to home, doctors wait for the patients, and at such a low cost.  

The patients can get to major cities, where these specialty doctors are available, within an hour or two.  With the extensive, frequent, and inexpensive transportation system in South Korea, getting to major cities is easy and affordable.  In sum, access to doctors is not a problem in the “rural” areas of South Korea as implied by the Moon administration.

What is the government’s policy?

The government implied there are three problems: a shortage of doctors, not enough doctors in rural areas, and not enough doctors in less desired fields.  The first two are not really problems, as the access to doctors is excellent in South Korea, as pointed out previously.  The third point–not enough doctors in “vital” fields–is true, but the problem has to do with disincentives, including relatively lower pay due to low fees set by the government and high risks of lawsuits and imprisonment.

In fact, the doctor’s organization has been trying to work with the Moon administration to address these problems for years, but with no avail.  Since the financial losses also discourage the hospitals from hiring more doctors, paying the actual cost of the surgeries and procedures plus extra is probably the most effective way to give incentives for the hospitals to hire more doctors in the “vital” fileds.  Instead, the Moon administration and his party came up with an elaborate plan that will take away health care resources even more, but that will not address any of the issues that the government emphasized.

The Moon administration announced it will increase the number of medical students.  The government decided to increase the number of medical students (currently 3,058) by about 400 a year for 10 years starting 2022 through the creation of government-run medical schools. (2:22)  The cost of the public medical schools, including tuition, room and board, and other expenses, will be fully funded by the taxpayer.  The plan is to make 300 of these medical students go into less desired specialties and commit them to work in rural areas for 10 years, while assigning the other 100 students to basic science and public health research. (2:34)  The entry will be based on recommendations from government officials, such as governors and mayors, and “civil society” organizations, not superior grades.  This policy is filled with numerous problems such as corruption, government control, and lowering the standards of health care in South Korea.

The Moon administration did not solicit inputs from the professionals–the doctors–in the decision.  It was made by fiat.  When the doctors have requested to have discussions with the government, the Health and Welfare Ministry’s position is that the decision was already made and they can’t make any changes.

Additionally, the ruling Democratic Party of Korea (Deobureo Minjoo Party), introduced bills to designate doctors as a “public good” to mandate them to do the government’s will and to force them to go to North Korea.  The bills will be discussed in the “Nationalization” section below.

To make the case of “doctor shortages,” despite the great access to medical care, the government cited that South Korea needs more doctors, because South Korea’s doctors per 1,000 was 2.4 in 2019, which is below the OECD average of 3.4 per 1,000.  Another alleged reason is to increase the number of doctors in the rural areas by having the medical students who graduate from the new government’s medical school commit to 10 years, which in reality would be more like 3-4 years in the rural area.  The government also claimed that increasing the number of students will solve the imbalance in doctors not going into less favored fields, such as general surgery (including neurosurgery and cardiothoracic surgery), internal medicine, pediatrics, and OB/GYN.

Dr. Shin stated on his YouTube channel “Doc Shin” that the Moon administration’s policy to build brand new government medical schools, train doctors in the shortage fields in rural areas, and mandate service on the public medical school students will fail, because the government has not correctly identified the problem. (3:22)  He states if there is a problem, it’s important to correctly identify the problem and to address the fundamental problem in order to resolve the problem.  (3:44)

Will expanding the number of medical students increase the doctors working in rural areas, one of the “problems” cited by the government?  It takes a long time (11-14 years, but usually 13-14 years for “vital” fields) to grow medical students into full-fledged doctors.  In South Korea, medical students enter medical school directly after high school, unlike in the U.S. where a medical student enters medical school after getting a bachelor’s degree.  However, the medical school is longer in South Korea–6 years.  They go through an additional training period of internship and residency (about 5 years), or even fellowships (1-2 years) in some instances, before becoming full-fledged doctors. (5:55)  In that case, they only have 3-4 years left of the 10 year commitment.

The new government medical schools, it turns out, do not have associated hospitals on site, which is odd.  In order to produce one highly qualified “vital” field doctor, it requires a sizable hospital with good facilities, support personnel, and professors who can train the doctors in their specialty, and lots of patients who require their treatment. (6:58)  However, the government medical schools that are planned to be built have no such hospital and are in a region with not enough population density for enough patients of a particular field.  This means they have to go elsewhere away from the rural area for internship, residency, and fellowship.  Where will the medical students get their training?  The authorities say the students and graduates will receive practical training and conduct their internship and residency at the National Medical Center located in Seoul. (5:40)  Only 3-4 years are left in their 10-year commitment after their clinical training.  After that, they are not likely to stay in the rural area.  A young physician on YouTube asks if after 10 years, will the doctor who were forced to work in that specialty in a rural area stay there and continue to practice in a specialty s/he may or may not like, adding that he chose his specialty because he likes it and is proud of his field and will remain in the specialty.  (6:21)   

This arrangement does not fit the government’s stated purpose, but rather contradicts it, as they will spend more time practicing in Seoul than in the rural areas.  Due to the availability of initial care even down to the villages and the proximity to specialized care, this “rural shortage” is  not even a problem to begin with.  The taxpayers’ money can be far better used to address the crux of the problem, which is the lower-than-cost fees, which then forces the hospitals to operate at losses, creating an unsustainable situation.

Increasing medical students does not solve the fundamental problem that dissuades the doctors from going into “vital” specialties or rural areas.

Why build government medical schools and change the admissions procedure?

It turned out the decision to build the new government medical schools–both in Jeolla Provinces–was already made.  The establishment of Namwon National Public Health University (one of the government medical schools) was made public, when the Democratic Party of Korea and the government officially announced on July 23, 2020 that they would pursue the establishment of a public medical school and that the school would be in North Jeolla Province.  Even the land for the school site was already acquired.  The city of Namwon in North Jeolla Province revealed on May 25, 2020 that “to prepare for the establishment of a public medical college, the compensation for 28,944 square meters (7.152 acres) of land, which is 44% of the total land [for the medical school site that totals 16.25 acres], was completed as of May.”

South Jeolla Province also appears to have been chosen to be the home of another government medical school, as indicated by the provincial government’s sign in the photo above, confirming the establishment of a medical school, calling it a victory for the 2,000,000 South Jeolla Province citizens.

Jeolla Provinces, both North and South, heavily support the Moon administration.  If the budget is already allocated for this purpose, then they already knew of this when the ruling party, along with 4 smaller non-ruling parties, forced through the super budget on December 10, 2019 by excluding the main opposition party and quickly voting on the budget.  Prior to the voting, they moved the budget to favored political projects, many of which were destined for the Jeolla Provinces.  19 of 33 lawmakers from smaller political parties who cooperated with the ruling Democratic Party of Korea were from Gwangju and Jeolla Provinces, where W1.1 trillion ($923 million) were shifted from other parts of the largest budget in South Korea’s history.   It smacks of a pork barrel project.  Not only the purchase of the land and construction costs, but also the cost of educating the medical students will be borne by the taxpayers.

The entry process also is problematic.  The current system places emphasis on grades and the teaching medical doctors assessment of candidates in selecting medical students for admission to medical schools.  In effect, the medical schools select the best of the best.  The government, however, came up with a new procedure of admissions based on the recommendation letters from politicians, such as governors and mayors, and “civil society” organizations. 

Ahn Gi-jong (안기종), the president of Korea Alliance of Patients Organization (한국환자단체연합회), which supports the creation of public medical schools, has said “I wish government medical schools wouldn’t select students who score the highest in the entrance exams.  I hope they don’t become schools for only first rate students.  A lot of people want to go to medical schools, but they can’t because of their low grades.  I really hope they are not places where only the best of the best students can attend.” in December 2018.  The Korea Alliance of Patients Organization is probably one of the “civil society” organizations that will select students for entry to the government medical schools.  This portends lowering standards for not only the public medical schools, but also the future generation of doctors.

The problem of this new process is the quality of the students and the increased potential for corruption and producing more situations like the controversial Cho Kuk’s daughter’s admission to universities and medical schools.

In Cho Kuk’s case, his daughter Cho Min, has entered universities not on testing, but her high  school “internship” experience, in which she received credit as the 1st author (ahead of doctors and full time researchers) of a thesis based on a 5-year long medical experiment project that was published in a medical journal.  She did not (and could not) participate in the project nor did she write it during her 2-week internship, yet she was not only given credit as an author, but as the author #1, ahead of doctors, who actually worked on the project.  The article was withdrawn after the discovery of this fact and  controversy arose, including demonstrations.  Cho Min also received scholarships at a medical school, despite her failing grades of an F in two of the classes, and her professor’s reason for giving her scholarships was so she would not drop out of the medical school.  Cho Kuk was a senior official at the Blue House under Moon, and subsequently appointed as the Justice Minister despite myriads of controversy over corruption and other charges.  In October 2019, the angry public protested over the favoritism his daughter received in medical school entry, which clearly was not based on merit, but on her father’s senior position in the government.  

The idea of those who have no knowledge or experience in the medical field making decisions on who gets chosen to go to the government medical school under this kind of circumstance naturally lead the public to question the government’s decision and motive, especially since corruption by Moon administration’s officials is not investigated or their investigations are often curtailed.

The worse case scenario is that as the system of selection to these medical schools changes from selecting the best and the brightest to a nomination system, it will create more corruption and bribery problems and lower the quality of the medical students and doctors from these medical schools, which then would increase the risks to the patients’ lives.  This would be even worse, if the government ended up assigning those with lower quality to less-desired, but very challenging fields such as neurosurgery or heart surgery.  These measures impact all who live in South Korea, citizens and foreigners, who receive medical care at some time in their lives.  Thus, this is not just the resident doctors’ issue; it’s an issue for all those who live in South Korea.

Controlling the medical sector

1,000 government medical school students (100 government medical school students out of 400 per year for 10 years) are designated to go into teaching and research, per the hardly advertised government plan.  Even the government did not mention any shortages in this field.  In fact, medical school professorship is difficult to get.  So why is the government doing this? Medicine and religion (Protestants specifically) are two sectors in society that the current government does not control, unlike the media, National Assembly, the judges, the prosecutors, the police, many “civil society” organizations, labor unions, and so on.  Placing 1,000 graduates from government medical schools, whose criteria for placement may be ideology in line with the Moon administration, which is pursuing socialism, is akin to creating a Jeongyojo (Korean Teachers and Education Workers’ Union) for medical schools throughout the country.  Jeongyojo is under the militant Korean Confederation of Trade Unions (KCTU). They both are pro-North Korea, pro-Chinese Communist Party, anti-U.S. and anti-South Korea as a liberal democracy.  Just as Jeongyojo has been teaching the young minds false history, such as not only de-emphasizing that North Korea started the Korean War, but also falsely claiming that South Korea started it, this new group of medical school professors could be conducting ideological indoctrination for future generations of doctors befitting the government’s nationalization efforts.  

Those who do not go into teaching could enter various medical associations to dominate those organizations in order to control them, similar to the method they used to grow lawyers and judges, placing them in “civil society” organizations such as Minbyun and Our Law Society, and later appointing them to key positions, such as Supreme Court justices.

Nationalization of medical care professionals

While the medical school issue does not seem like the government is nationalizing the doctors, there are other steps the government is taking.  The ruling Democratic Party of Korea (Deobureo Minjoo Party) introduced bills that are problematic.

One is a bill introduced by National Assemblyman Hwang Un-ha (황운하), Democratic Party of Korea, designating doctors as a “public good.”  On August 27, 2020, Hwang Un-ha (Ministry of Trade, Industry and Energy Small and Medium Venture Business Committee) announced the introduction of an amendment to the “Basic Act on Disaster and Safety Management.”  Hwang added “physician personnel” as part of “disaster management resources,” which meant only material goods in the past, not people.  Doctors are private citizens.  Most of the doctors paid for medical school by private means (families, loans, etc.) and work in the private sector.  The nationalization of doctors is found in countries like Cuba, where the state essentially owns the physicians and exports their labor overseas for hard currency.  This attempt to nationalize its citizens, in this case doctors, in South Korea is indicative of what the Moon administration and his party are trying to do to South Korea’s liberal democracy.

[Note:  Hwang Un-ha is mired in the Blue House election interference in the 2018 local elections  scandal, and he was under investigation.  At that time, Hwang was the Ulsan city police chief.  He investigated the incumbent Mayor Kim Gi-hyeon (김기현), Liberty Korea Party, who was running for re-election, 3 months prior to the election.  The Blue House was alleged to have directed Hwang to investigate Kim, and Kim lost the mayoral election.  The Blue House election interference became a scandal and the prosecution team began investigations, including investigating Hwang.  It was illegal for Hwang to run to be a lawmaker, since he was still the police chief and was under investigation, but he ran for office anyway.  The investigation of Hwang and others fizzled away under pressure from Justice Minister Choo Mi-ae, newly appointed by Moon Jae-in.  For details, see here.]

The second bill, introduced by Shin Hyun-young (신현영), a proportional representative of the Democratic Party of Korea, calls for sending “South Han (South Korea) health workers” to North Korea, as if the doctors and nurses are owned by the government.  Whatever the reason, the government cannot force the doctors and nurses to go to North Korea.  Other than the fact that the government cannot guarantee they will not be held hostage, the majority of the doctors and nurses in South Korea are in the private sector.  They or their families pay for medical school.  They receive their training at private hospitals.  The government cannot mandate that they go to North Korea or even within South Korea.  Yet the Moon government wants to change this.  They want to own the doctors, like they do in Cuba.  The Cuban government creates medical doctors enmass, exports their labor for hard currency, and confiscates the majority of the doctors’ earnings, similar to North Korea exporting construction workers for hard currency and confiscating most of their earnings.

The doctors refuted, “It is the law to compel medical personnel to go to North Korea” and “Why don’t you go? I’ll never go.”

If the government’s measure of the quality of care is contingent upon the number of doctors per 1,000 as the Moon administration implies, then this bill is also contradictory.  According to the World Bank data, North Korea had more doctors per 1,000 than South Korea in 2017–3.7 for North Korea and 2.4 for South Korea.  By comparison, Cuba has 8.3 per 1,000, the highest in the world.  Yet, neither North Korea nor Cuba come close to the high quality of health care South Koreans receive.

Moon Jae-in’s social media post and 42,000+ comments

Moon Jae-in’s controversial Facebook post, September 2, 2020

Moon Jae-in’s Facebook post on September 2,  2020 in response to the young doctors’ strikes was controversial as he tried to pit the nurses against the doctors, but it backfired.  He thanked the nurses for covering for the residents, who left to conduct strikes and blamed the doctors for placing extra burden on the nurses.  He also surmised that the “healthcare providers” who fought against the Coronavirus pandemic were “mostly nurses,” implying the doctors do not deserve the appreciation for their hard work in taking care of COVID-19 patients.  It turned out that was factually incorrect, in addition to its obviousness in efforts to divide the doctors and nurses.  As of September 7, 2020, over 42,000 comments were posted, mostly chiding Moon for portraying doctors in a negative light and trying to play the nurses against the doctors.

Netizens’ comments:

• How childish! He doesn’t even know the difference between doctors’ responsibilities and nurses’ responsibilities…he’s an expert in playing one against the other.
• Even elementary school students would get scolded by the teachers for fanning the flame to fight and to play one against the other.  Who scolds president Moon Jae-in? We are citizens!
• This can’t be Moon Jae-in’s writing.
• Is this really written by the president of the Republic of Korea? Really?
• Dividing the citizens; Separating people; Playing one against the other; Split & take sides; communism/socialism’s typical ruling method.
• I escaped from North Korea where the compensation for the doctors was the same as mine.  If that becomes a reality [in South Korea], then the citizens at large won’t be able to get treated.  Listen to those who experienced socialism first hand in North Korea.  North Korea forces doctors into forced labor and trains them in ideology. Doctors are the innovative elite group in capitalist society. They want to push the doctors’ brain functioning level downwards and equal.  Then the citizens will not be able to get quality health care, especially those with no money.  In the Republic of Korea, the doctors are the final frontier of freedom.
• You had to write such a post in order to split the doctors and nurses and pit them against each other…yet again, I’m disappointed.  Please do not use the precious sacrifices of the nurses and us for political purposes, but rather, please wake up and try to solve the current crisis.  And increasing the number of nurses…the next target are the nurses.
• Doctors are looking after patients of the striking doctors.  We sent the residents (to strike) and difficult tasks are handled by the full-fledged doctors.  The doctors are doing doctors’ work and the nurses are doing nurses’ work.  Please do not divide us.  If you really want to thank the nurses, just say thanks…until the residents return, we’ll cover for them, even if we collapse…
• Don’t use the nurses. Do we look stupid?
• Did your account get hacked?

What are others saying?

The government and the majority of the major media (controlled by the National Union of Media Workers, which supports the Moon administration and its pro-North Korea, pro-China policies) have portrayed the striking doctors and medical students as greedy and uncaring people, but that is far from reality.  The doctors know that the government’s fiat will ruin the health care system in South Korea.  However, their voices are not carried by the major media.  Here’s what the supporters of the young striking doctors are saying.

Professor Lee Un-hye, Soonchunhyang University Medical School, said the doctors were just working hard as usual when the government brought the fight by making nonsensical policy. The medical side saw that it was wrong and wanted a dialogue with the government…There’s no need to build separate government-run medical schools to supply doctors to public health institutions, since private medical schools already produce MDs for both private and public sectors.” (2:39)  Another problem is the selection process.  Rather than students entering medical schools based on entrance exams, a committee that includes “civic society organizations” will nominate students.  Who exactly are they trying to let become doctors? And what kind of doctors are they trying to make? I’m so worried about our citizens’ future.  (2:54) Regarding the “shortage of doctors in the rural regions,” she said in order to correct the problem, one has to correctly diagnose the problem, but that has not been done. Instead of seeking the reason, the government is just focused on increasing the number of doctors through new government run medical schools. (3:59)  She said, “this worsens the problem.  So I’m really frustrated. If these people (the Moon government) are doing this because they really don’t know, they all need to resign.  They’re not qualified.  But them doing this despite knowing what the problems are…they really view the citizens as dogs and pigs (mentioned in George Orwell’s Animal Farm), so I’m really upset.”   She assessed the Moon administration’s health policy is based on the Moon administration personnel’s efforts to infuse politics with their beliefs, ideology and their own benefit. (7:00)

Professor Choi Se-hoon of Thoracic Surgery Department at Asan Hospital in Seoul stated “It is the government that is clearly in the wrong.”  Dr. Choi supports the strikes, stating,”knowing how the future will change (for the worse) due to the 4 evil policies, it would be not understandable if they did not strike.”

Another doctor even put a petition on the Blue House Petition website, imploring Moon to stop the war against the doctors. 

I am a professor of internal medicine in the area of essential medical care at a local medical school. I have been caring for patients since the coronavirus outbreak so far without a single day off or annual leave. The professors at our hospital have been treating the Coronavirus Screening Clinic in addition to their work without complaining.

When treating COVID-19 patients, the professor of infectious medicine at our hospital did not transfer work to the trainees, but went directly to the negative pressure bed for treatment. That key condition that made it possible for him to do so was the presence of residents and intern doctors who were in charge of other patients outside. In this situation, causing all of the following full-time trainees [residents and interns] and medical students to leave the places of medical practice is the same thing as cutting the hands and feet of commanders fighting in the battlefield.

Who started this fight in the first place? It is the government that pulled the knife on the doctors who were going about their business of treating patients; it was not the doctors, who started the war. Therefore, it is the government, not the doctors, who hold the key to the solution to stop this war.

Summer is waning and autumn is near. When the cold wind starts to blow, not only the Coronavirus, but the general flu will begin to spread. It is during fall and winter, when infectious diseases, such as pneumonia, as well as cardiovascular diseases, such as myocardial infarction and stroke, increase. [Truncated]

In this desperate time, I don’t think threatening the interns, who are only in their 20s, that the government will cancel their licenses is the proper judgement and act of the leader of a country, who is responsible for preventing a pandemic.

It goes on imploring the journalists to “stop producing partial and low-quality articles” that describe this issue as only a “rice-bowl fight” [portraying doctors as only interested in money], but instead to report on the real reason for the problem.

Dr. Choi Dae-jip (최대집), the chairman of Korean Medical Association (KMA) has been known to be a fighter.  He posted on his social network account, “The current behavior of President Moon Jae-in, who claims that he advocates for democracy, is a complete denial of liberal democracy, and is the behavior of the fascist leaders who ruled Europe in the early and mid-20th century.”  When Moon criticized the young doctors by pointing out “The medical personnel leaving the medical field in the event of a coronavirus crisis is the same as the soldiers leaving the battlefield in a wartime situation,” Choi retorted, “President Moon’s sudden enforcement of the 4 major evil medical policies in the Coronavirus crisis is like ‘shooting our soldiers in their backs during a wartime situation.’”  Regarding the government not banning entry from China in the early days of the COVID-19 crisis, he stated “It is the same as asking allied soldiers to hold their positions, while opening the gate wide to the enemy forces during wartime.”  As a result, he said, “130,000 doctors in South Korea had to deal with the pandemic starting mid-February and barely managed the situation.”  Choi added, “Most of the doctors in the Republic of Korea are not government employees.  As free individuals working in the private realm, they are not those who the president and the government can order around” and implored the cessation of suppression of the doctors’ basic human rights and freedom.”  On August 26, 2020, Choi adjured the young doctors to continue with their protest, stating “I’ll go to prison (if it comes down to it), so younger doctors, do not give up, keep fighting until the end.”

Given Choi’s stance and record, it was a surprise when it was announced that Choi reached an agreement with the ruling party and the Ministry of Health and Welfare on September 4, 2020.  The Korean Intern Resident Association (KIRA, 대한전공의협의회), shocked, initially asked Choi for an explanation of his decision.  The young doctors were furious that the “agreement” did not address any of their concerns.  The outcome was “Re-engaging from the starting point” discussion of increasing the number of doctors and establishing public medical schools “after the Coronavirus situation is stabilized .”  It did not contain any of KIRA’s demands, such as the withdrawal of bills related to public medical schools, promise to implement policies for health care system development, and National Health Insurance Act revision.  The interns and residents criticized Choi, stating “everything we’ve been fighting for has been for naught.” 

It is also strange that only the ruling party, not the National Assembly, was at the table.  It is as if South Korea is a one-party state and the Democratic Party of Korea is the one party.  With the super majority of 180 of 300 seats at the National Assembly–enough to pass any bills the party wants, except those requiring 2/3 majority, such as the constitution–the ruling party behaves like a party in a one-party state.  The controversy over how the ruling party obtained such a large majority, gaining 60 seats in the April 15, 2020 elections, is yet another matter.  For election fraud issues, see here, here, and here.

Moon’s goal

The Moon Jae-in government has been criticized due to its authoritarian tendencies, suppression of defectors and human rights organizations, suppressing freedom of speech by jailing journalists, and suppressing freedom of religion.  At the same time it is taking a hard line against the doctors, it is also suppressing freedom of religion as well as anti-Moon Jae-in rally goers by placing blame on them for the increase in Coronavirus spread.  These illiberal acts that undermine South Korea’s liberal democracy began with his presidency.  Moon, who said he wants to “share in the Chinese dream,” is reorienting South Korea away from the U.S. toward China and North Korea, and is pursuing policies toward socialism/communism.

The Moon administration has taken over the media, the legislative branch, the judiciary branch, and other segments of South Korean society.  South Korea has become a society in which a journalist is sent to jail for “defaming” former Blue House official Cho Kuk, a citizen is sentenced to 10 months in jail for calling Moon a communist, and a human rights activist, a defector from North Korea is harassed and threatened with imprisonmnent for sending leaflets to North Korea. The ruling party has introduced numerous bills to criminalize its citizens–jail terms for owning multiple houses, for discussing/challenging the official narrative of history, sending leaflets to North Korea, etc.–which can only be seen as efforts to suppress free expression even more.

There are two groups in South Korea that the Moon administration does not control–the medical community and the church.  With the latest hard line behavior, the Moon government is showing its intention to bring them under its control.  

If the Moon administration and his party succeed, the doctors will become commodities and the government will determine what the doctors may or may not do, while destroying the excellent standard of health care that the South Koreans have built, while introducing corruption that favors the ruling class–the Moon administration and his party.  That is why the young doctors are on strike. 

This issue, however, is a lot more damaging for South Korea beyond lowered health care standards, as it is part of a bigger plan to reduce the private sector and increase the state ownership–and reduce freedom along with it–a path to socialism and communism, pursued by not only Moon, but many of his appointees.  As the escapee from North Korea, who commented on Moon’s social network post about the doctors, stated above, perhaps “the doctors are the final frontier of freedom” in South Korea.