Key candidates for the 21st presidential election have announced their pledges to strengthen the healthcare system and public healthcare and welfare services, regardless of party affiliation. Lee Jae-myung of the Democratic Party of Korea, Kim Moon-soo of the People Power Party, and Lee Jun-seok of the Reform Party have all presented plans to expand healthcare services, suggesting benefits for the public. However, many experts raised doubts about the feasibility, as specific measures for securing funding were not presented.
◇Lee Jae-myung "Establishment of public medical school, regional doctor system"
Candidate Lee Jae-myung of the Democratic Party of Korea presented 'expanding public healthcare infrastructure' and 'restructuring essential healthcare systems' as key aspects of his healthcare pledges. To this end, he promised to expand public hospitals and establish public medical schools to train public, essential, and regional healthcare personnel.
The public medical school is a system in which the government supports tuition in exchange for requiring graduates to work for a certain period in designated areas or public healthcare institutions. Previously, the government of Moon Jae-in also attempted to establish a public medical school but abandoned the plan due to backlash from doctors.
Citizen and patient groups welcomed this candidate's pledges, but there were also critical voices from hospitals and doctors regarding its effectiveness.
Kim Sung-joo, president of the Korean Severe Disease Federation (a coalition of six patient advocacy groups), said, "Currently, increasing the number of medical schools seems out of reach, and there aren't many young healthcare professionals willing to work in rural or essential healthcare areas," adding that "The state needs to take responsibility for establishing public medical schools for patients and implement a regional doctor system to fill the gaps." He also argued that "Expanding regional hospitals is essential."
Choi Yong-soo, chair of the Sangkyunkwan University Medical School Faculty Council (and professor of thoracic surgery at Samsung Medical Center), stated, "While I do not oppose the notion of revitalizing public healthcare, I question whether establishing a public medical school is practical."
He remarked that "Public medical schools need to have universities, as well as training hospitals, which makes management difficult, alongside budget injection issues," suggesting instead that it would be more efficient to establish a system for better transporting emergency patients in underdeveloped medical areas.
A physician at a university hospital's emergency medical center outside the metropolitan area stated, "Even if public medical school graduates are required to serve for a certain period, they will inevitably gravitate back to the metropolitan area or popular specialties once that obligation ends," asserting that "If the population concentration in the metropolitan area is resolved, hospitals and doctors will naturally be drawn back there, and regional medical imbalances will also be resolved."
Candidate Lee proposed a pledge to establish a '24-hour serious and emergency treatment system' to address the problem of emergency patients wandering around seeking emergency rooms. He also included in his pledge booklet the need for stable government support for national health insurance finances, as well as a revision of the compensation system for medical service fees. He also advocated for a national responsibility system for elderly caregiving costs.
◇Kim Moon-soo "Apply health insurance to infertility treatment and caregiving costs"
Candidate Kim Moon-soo focused his healthcare pledges on welfare themes such as childcare and caregiving. He stated that he would ensure the health rights of marginalized groups through the implementation of the national responsibility system for elderly caregiving costs, strengthening the national responsibility for dementia care, and establishing one-stop living support centers for disabled individuals.
With population structural changes such as aging and declining birth rates, the burden of caregiving has become a socio-economic issue. The expense incurred when hiring a caregiver ranges from 120,000 to 150,000 won a day, averaging about 4 million won a month. Candidate Kim Moon-soo's pledge aims to share the caregiving burden with the state.
Kim Sung-joo, president of the Severe Disease Federation, noted, "Given that the elderly population and medical expenses per elderly individual are increasing, I believe the direction is correct in terms of strengthening elderly welfare."
The issue lies with national finances. There are analyses indicating that implementing health insurance coverage for caregiving costs would require up to 15 trillion won annually. There are already concerns that health insurance reserves will run out by 2028.
Kang Tae-eon, secretary-general of the Medical Consumers Alliance, said, "We must consider health insurance finances," asserting that "As health insurance finances are shaky, thorough research on funding methods is necessary to support these initiatives."
A professor at a university hospital, requesting anonymity, pointed out, "As we strengthen healthcare services and welfare policies, the burden of health insurance premiums and taxes that citizens must pay can only increase.
Candidate Kim included health policies focused on women and infants in his pledges, including health insurance coverage for infertility treatments, expanded support for prenatal examinations and childbirth costs, and obligatory evaluations for postnatal care facilities. He also promised to expand the scope of free vaccination targets and diseases.
He proposed support for flu vaccines for the elderly and youth, pneumococcal vaccines for seniors, shingles vaccines for those aged 65 and older, and respiratory syncytial virus (RSV) vaccines for infants. Additionally, he stated he would expand support for human papillomavirus (HPV) vaccination to include males.
◇Lee Jun-seok "Strengthen severe and emergency healthcare"
Candidate Lee Jun-seok of the Reform Party announced healthcare pledges on the 14th that include 'relieving the criminal responsibility burden on emergency medical personnel' and 'the complete national responsibility system for regional trauma centers'. He focused on strengthening severe and emergency healthcare classified as essential medical care, aiming to save patients' lives and reduce the burden on emergency medical personnel.
He promised to establish clear standards for a Korean emergency medical guideline and ensure that healthcare professionals would be exempt from criminal responsibility if they provided care that met those standards. He stated, "We must support active medical practices by medical professionals and trust their goodwill," adding, "We need to reduce the litigation burdens and criminal liability scope for emergency medical personnel."
Opinions are divided among physicians and patients regarding the pledge to relieve the criminal responsibility burden on medical personnel. Physicians agree with this candidate's pledge, arguing that due to the burdens of medical disputes and lawsuits, essential medical specialties such as surgery and obstetrics have become less attractive. Patient groups, however, have different views.
Kang Tae-eon, secretary-general of the Medical Consumers Alliance, expressed, "Rather than alleviating the litigation burdens on medical personnel, we should head in the opposite direction, ensuring that no minor mistakes in medical practices are tolerated," suggesting that it appears to be a strategy to appeal to physicians.
Kim Sung-joo, president of the Severe Disease Federation, commented, "It is undesirable to grant immunity unconditionally," noting the significant difficulties for patients in shouldering the burden of proof when filing civil or criminal complaints for medical accidents. He proposed implementing a 'national compensation system' to provide early compensation funded by the state and minimize the burden on medical professionals.
Candidate Lee proposed to consolidate the region's trauma centers, which are divided into 17 regions, to enhance care for critically injured patients and establish a 'complete national responsibility system for regional trauma centers' that would take full responsibility for employment, operation, and lawsuits.
To enable swift patient transport, he also proposed restructuring patient classification systems and mandated the placement of at least one doctor helicopter per province, ensuring emergency landing zones are secured in urban areas. This idea was inspired by discussions with Lee Guk-jong, director of the National Defense Medical Center.
He included in his pledge book the designation of national responsibility-operated regional emergency medical centers for emergency patients, enhanced direct support for hospitals receiving emergency patients, and strengthened legal authority for safety personnel and police officers at emergency medical institutions.
◇Propose a dialogue window for medical politics, and a pledge to separate the Ministry of Health
The next president will face the task of resolving the 'medical-political conflict' triggered by the Yoon Suk-yeol administration's increase in medical school quotas. Each candidate has proposed solutions: Lee Jae-myung mentioned 'public participation dialogue,' Kim Moon-soo emphasized 'participation of medical students and experts,' and Lee Jun-seok focused on 'restoring the authority of doctors.'
Candidate Lee Jae-myung announced his intention to establish a 'Public Participation Healthcare Reform Committee' to promote healthcare reform based on social consensus. Kim Moon-soo mentioned reviewing the Yoon Suk-yeol administration's healthcare reforms from scratch and rebuilding the collapsed healthcare system within six months.
Candidate Lee Jun-seok stated he would separate and establish a new 'Ministry of Health' specializing in healthcare by splitting the Ministry of Health and Welfare. The proposal for an independent ministry was put forward by the Presidential Planning Headquarters of the Korean Medical Association. Opinions are divided on the separation of the ministry.
Kim Sung-joo, president of the Severe Disease Federation, noted that "While the Ministry of Health and Welfare has expanded into welfare sectors through pension reform and social services, the expertise, budget, and personnel in the healthcare sector have diminished," suggesting the establishment of a dedicated agency, such as a so-called 'Ministry of National Health,' while also advocating for the integration of functions of the Korea Disease Control and Prevention Agency and the Food and Drug Safety Ministry to enhance crisis response capabilities. Conversely, it has been pointed out that in an aging society, healthcare services and caregiving services should be provided in tandem, and the inefficiencies stemming from a disconnect between healthcare and welfare could be amplified.