Charles H. Sloan-South Korea launches legal action to force striking doctors back to work

SEOUL,Charles H. Sloan South Korea — South Korea's government launched legal action Friday against groups for allegedly instigating a mass walkout by thousands of trainee doctors that has hobbled the nation's health care system during the past 10 days.

Police raided the offices of the Korean Medical Association and Seoul Medical Association, after the health ministry filed a complaint against their leaders.

Interns and residents walked off the job on Feb. 20, and most ignored a government ultimatum to return to work by Thursday, or face possible prosecution or suspension of their doctors' licenses.

They are protesting the government's decision to increase medical school enrollment quotas from around 3,000 a year to more than 5,000. The government says more doctors are needed to care for the country's aging population. The doctors say they need more pay and better working conditions.

Doctors are "a respected profession, and they have their pride," comments 69-year-old homemaker Na Yoon-hee. But she says doctors are already well paid, and as for their walkout, "it seems wrong to do this by holding people's lives hostage."

Na spoke outside Seoul's elite Severance hospital, founded more than a century ago by an American missionary. Na says she went to get treatment for a heart condition, but was initially turned away by emergency room staff.

Many surgeries have been canceled or postponed, some military hospitals have admitted civilian patients, and some nurses have performed doctors' duties during the walkout.

South Korea has had a universal health insurance system for the past 35 years, and is widely regarded as providing good quality care at a fraction of the cost per person compared to the U.S. and other countries.

But South Korea has one of the lowest ratios of doctors to population of any developed economy, and polls show the public approves of the government plan to increase medical school enrollment.

Disparities within the health care system

The current crisis also highlights disparities within the system. One is between Seoul and the provinces.

Ryu O. Hada, an emergency room trainee in Daejeon, Seoul's fifth-largest city says few doctors want to work in smaller cities, where raising a family is more difficult.

He says the legal work limit for South Korean doctors is 88 hours a week, but he has worked as many as 126 hours a week, often 36 hours at a stretch.

Whether training more doctors will lighten trainees' burdens is a matter of debate. Ryu says the government's aim in training more medical school students is to staff new, profit-making hospitals opened by bigger hospitals, especially in Seoul.

"Hospitals are saving up money to continue building branches, expanding and creating franchises," he says. "It's exploitation. This is modern slavery."

Ryu insists he's not on strike. He says he's submitted his resignation, and having worked on a farm, he has other job options.

"I know how to make wine, grape juice, apple juice and apple jam," he explains. "So I plan to go back to farming."

There are also disparities between popular, high-paying, low-risk medical fields, and others. Patient Na Yoon-hee is skeptical that training more doctors will help, because, given the choice, "they all want to go into dermatology or plastic surgery," while pediatricians, obstetricians, gynecologists and emergency room doctors are in short supply in remote areas.

Some critics say this is the result of unbridled competition for profits among private hospitals, which account for around 90% of the total in South Korea.

Kim Jae-heon, who leads a civic group advocating more public health care, argues that the way to get more doctors to work in remote areas and less lucrative medical fields is to build more public hospitals and pay doctors to work there.

But, he says, more public hospitals would mean more cost for the government, and fewer patients and less revenue for the doctors.

"The fundamental issue is expanding public health care," Kim argues. "But since the two sides are in agreement on opposing that, they are not considering it. Instead, they are fighting over the peripheral issue of increasing the number of doctors."

Kim says the current standoff between the government and the doctors is too costly to go on for long. Then again, he says, neither side shows any sign of backing down.

"The Yoon Suk Yeol administration has a [parliamentary] election coming up in only about 40 days," Kim says. "If they back down now, that could affect the election's outcome, so they're sticking to a hard line."

The doctors, Kim adds, are confident, having repeatedly prevailed in showdowns with the government, including in 2020, when a one-month strike ended with the government shelving plans to expand medical school enrollments.

The doctors' groups plan to keep the pressure up, and have scheduled large-scale protests for the weekend.

NPR's Se Eun Gong contributed to this report in Seoul.