SEOUL – Talk about a perfect storm. At a time when the country was undergoing its second-biggest Covid-19 surge, and with a monster typhoon bearing down on the peninsula, tens of thousands of doctors began a strike in South Korea.
The three-day collective action is being waged by interns and residents in general hospitals and practitioners in clinics nationwide, who are members of the 130,000-strong Korean Medical Association, or KMA.
The casus belli is a series of government proposals on health sector reform, which would not only more than double the number of new medical school entrants over a decade, but would also extend national healthcare coverage for traditional Oriental medicine.
The impact of the strike is still being assessed.
A survey conducted by the Ministry of Health and Welfare found that 58.3% of nationwide medical facilities with trainee doctors were suffering from the strike, Yonhap news agency reported.
According to news reports, the number of operations at major hospitals in the Seoul area had nearly halved. Professor-level doctors have been drafted in to general hospitals to cover for interns and residents who usually man emergency rooms and oversee the critically ill.
The government has responded with strong, albeit generalized, statements.
On Wednesday, Prime Minister Chung Se-kyun said authorities will “deal promptly and sternly with the collective action” to “protect the lives and safety of the people.”
Speaking earlier in the day, President Moon Jae-in said authorities should respond “strongly.”
Meanwhile, South Korea is seeing its second virus surge after an earlier crisis was overcome in February-March, and a potentially record-breaking typhoon is predicted to hit the peninsula on Wednesday night and Thursday.
Medical turf war
The Korean Intern Resident Association (KIRA), which represents 16,000 interns and residents training in South Korea, laid out their opposition to proposed government health care workers policies in a press release sent to foreign reporters on Tuesday.
KIRA said the strike is aimed at government plans to “(1) increase the medical school entrance quota (4,000 extra students over a 10-year span), to (2) establish ‘public health’ medical schools and to (3) extend insurance coverage for oriental medicine.”
Given that the latest annual number of medical school entrants was 3,058, the government plan would more than double their number by 2031. Comparative figures, however, suggest that South Korea could comfortably increase its number of doctors.
According to World Bank Data, South Korea, a G12 economy, has 2.4 doctors per 1,000 people – more than China with 2.0, Singapore with 2.3 and the exact same figure as Japan.
However, South Korea’s numbers fall behind those of Canada and the United States with 2.6, Spain and the UK with 2.8, France and Ireland with 3.3, Russia and Italy with 4.0, Germany with 4.4, and Israel with 4.6.
Medical schools in South Korea are privately run, and priced accordingly.
A key issue that has long plagued healthcare in South Korea is the relative weight that health authorities and related funds give to modern, Western-style medicine, versus traditional Oriental medicine, such as acupuncture, moxibustion, massage and manipulation and herbal treatments.
One noted hospital in South Korea, Kyung Hee, offers patients both Western and Oriental medicine, but elsewhere, there is a rift.
A senior nurse at a major Seoul general hospital, speaking off the record to Asia Times, shed further light on the subject.
She said that while she and her colleagues were irked at the extra hours they are being forced to work by the strike, they support the industrial action by residents and interns.
The key issue angering medical professionals, she added, was that the government proposals, if enacted, will lead to a waste of public health funds, which are, by nature, limited.
Firstly, she maintained, the increased number of newly graduated doctors will be sent to rural areas, but the medical reality in South Korea is that patients with serious conditions customarily come to leading urban hospitals that offer the best facilities and the most experienced specialists.
Secondly, she said, a greater proportion of national medical insurance funds will, under the government’s proposal, go towards Oriental medicine.
Rising risks
The three-day strike is adding further pressure to a medical system already facing a recent and highly unwelcome resurge in Covid-19 cases.
There were 320 new infections registered nationwide on Wednesday, with 202 of them in the greater Seoul area. That is a rise from the previous two days, when infection numbers fell short of 300, but is also well below the five-month high recorded on Sunday of 397.
Those daily numbers, while far below those of many other major economies, are a shock to South Korea. The country underwent a crisis in late February and March, but through the widespread deployment of tests and the use of a high-tech contact tracing system, mastered it.
Only three weeks ago, South Korea was seeing daily infection rates in the double digits.
Cases have now been in triple digits for 13 consecutive days. Most blame for the recent rise in infections has fallen on massive anti-government rallies that took place in Seoul on August 15, and a mass outbreak at the Sarang Jeil (“Love Foremost” ) church, which was also heavily engaged in the demonstrations.
About 933 infections have been traced back to the church.
Other cases have emerged at the Army’s Cyber Warfare Command and at the government complex in the administrative capital of Sejong City, while clusters have emerged at coffee shops and door-to-door businesses.
From Wednesday, all Seoul-area schools returned to online classes, and according to TV news reports, the occupancy rate of Seoul hospital beds is 75.1%.
Given the risk of exponential infection in the greater Seoul area, home to 25 million people, the media are in a frenzy over whether the government will shift from the current Level 2 social distancing guidelines to Level 3, the highest level.
However President Moon, Prime Minister Chung and Korea Center for Disease Control and Prevention Director Jeong Eun-kyeong have all warned this week that a shift to Level 3, which would ban gatherings of more than 10 and would include the closure of large-size restaurants and bars, would cause serious damage to the economy.
Meanwhile, from Wednesday afternoon, fishing boats across the peninsula were tied up in harbors as an unusually powerful typhoon, Tropical Storm Bavi, approached.
It was bearing down on South Korea’s southernmost island of Jeju late in the afternoon, and on its present course, was expected to hit Seoul late on Thursday afternoon. According to weather reports, Bavi could break wind-speed records for typhoons passing over the Yellow Sea area.