An unprecedented doctors’ strike in South Korea is in full swing, disrupting medical operations and putting public health at risk.
The strike should be a wake-up call for Taiwan, which is also becoming a “super-aged” society and has for a long time had a shortage of medical workers.
At the center of the dispute that has caused young doctors in South Korea to walk off the job is a government plan to admit 2,000 more applicants to medical schools per year to cope with the country’s fast-aging population. South Korea has only 2.6 doctors per 1,000 people, a ratio that is among the lowest among Organisation for Economic Co-operation and Development (OECD) countries. Nearly 9,000 medical interns and residents, about 70 percent of South Korea’s junior doctors, have been on strike since Feb. 20 to protest the government’s plans. The South Korean government has threatened legal action against the striking doctors and suspension of medical licenses of up to 7,000 of them if they do not return to work.
A Gallup survey showed that about 80 percent of South Koreans were in favor of the government’s push to increase the number of medical students and its president’s approval rating climbed to a three-month high, indicating that he has gained support from people frustrated with the strike. However, most of the striking doctors have defied the government’s ultimatums and on Monday organized a huge rally.
The stalemate has sparked debate in Taiwan, which should be a sign to president-elect William Lai (賴清德) — a former physician who vowed to make improving public health services a priority — to focus on reforming the medical system, including the National Health Insurance.
More than one-quarter of Taiwan’s administrative regions are already “super-aged” societies, beating government predictions of when they would reach that stage. Taiwan as a whole is expected to reach the “super-aged” threshold of at least 20 percent of the population — or about 4.29 million people — aged 65 or older no later than next year.
Taiwan has one of the lowest fertility rates in the world. In 2002, 248,000 babies were born in Taiwan and the number fell to fewer than 136,000 last year. The birthrate decline has led to Taiwan having just 3.1 doctors for every 1,000 people, far behind the OECD average of 3.7.
Since 1998, Taiwan has capped medical school recruitment at 1,300. The Ministry of Health and Welfare has tried to add 100 government-sponsored medical students per year and opened the door to medical students from nine advanced countries to take the physician certification exam and practice in Taiwan, but doctors’ associations have opposed the policies. Meanwhile, hospitals face recruitment difficulties, especially in their pediatric, obstetrics and gynecology, internal, surgery and emergency departments. Some hospitals are forced to put senior doctors on night shifts.
Some physicians’ associations argue that the number of doctors rose from 49,000 in 2018 to 54,000 in 2022, but that broad statistic overlooks the crucial factor of uneven distribution, with doctors tending to prefer working in urban areas, where the pay is better, and in less-stressful departments. That leaves many rural heath providers understaffed, even with the government increasing subsidies for them.
The government must improve salaries and work conditions at under-staffed departments.
The government budget for medical spending in 2022 reached a record high of more than NT$1.7 trillion (US$53.86 billion). At about 7.5 percent of GDP, that was close to the OECD average of 8 percent, but lower than South Korea’s 10 percent, so there is plenty of scope for the government to redistribute resources. Medical reform is urgently needed to train talent and safeguard the health of Taiwanese.
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