Civic activists have rated four major presidential candidates' health and medical campaign pledges, and the score got worse as a candidate leaned to the right.

The Korean Federation of Medical Activist Group for Health Rights divided the four major runners’ healthcare pledges into four areas – strengthening public healthcare to respond to infectious diseases healthcare service, expanding insurance coverage, stopping for-profit healthcare, and community healthcare services. It then evaluated their campaign pledges in 16 categories.

The assessment was also based on the candidates’ replies to questions from voters’ networks to end inequity, the movement headquarters for blocking healthcare privatization and realizing free health service, and the presidential hopefuls’ comments on media outlets.As a result, Shim Sang-jeong, the candidate of the Justice Party (JP), recorded the highest score of 89, followed by Lee Jae-myung of the ruling Democratic Party of Korea (DPK) with 43, Ahn Cheol-soo of the splinter opposition People’s Party (PP) with 23, and Yoon Suk-yeol of the largest opposition People Power Party (PPP) with 17. Coincidentally or not, the scores proved proportional to candidates’ progressive tendencies.

Shim gets good rating in enhancing health service, poor marks in expanding insurance coverage

Shim won high marks by presenting detailed plans to strengthen health services, replenish medical workforce, and stop medical commercialization.

The leftist candidate promised to establish a public hospital to cope with infectious diseases and legalize the exemption of preliminary feasibility studies for public hospitals. Furthermore, to replenish the medical workforce, she vowed to stipulate an optimal number of nurses by law, set up a public medical school, and increase doctors providing essential treatment by introducing a mandatory service system at public medical institutions.

Shim also pledged to stop medical commercialization by opposing for-profit hospitals or the existing hospitals’ for-profit subsidiaries, regulating private health insurance, and placing a cap of 1 million won ($830) in annual medical expenses per person, putting forth a virtually free medical system.

However, the federation subtracted points for Shim’s pledges to expand public hospitals and expand insurance benefits by raising insurance fees.

“The pledge to secure a public hospital in 70 mid-level medical spheres is no more than establishing only one more public hospital in provinces with many vulnerable areas, such as Gangwon, South Chungcheong, North Chungcheong, and North Gyeongsang,” it said. “Also, the expansion of expanding insurance coverage is a right goal, but we have doubts about the propriety of its method its strategy to raise insurance fees to hit the target.”

the candidate of the center-of-left DPK, was the runner-up, receiving a favorable rating by pledging to replenish public hospital beds but getting deducted points for pushing for medical commercialization.

Although Lee vowed to replenish public hospital beds, the group said that he stopped short of presenting detailed ideas, such as exempting public hospitals from the preliminary feasibility study.

It also pointed out that Lee presented a regional nurse system and the enactment of nursing law, his plan could backfire. Besides, Lee failed to present specific data for establishing public medical schools and increasing enrollment data for existing ones, and there were no promises to obligate the graduates to work at public hospitals, the federation pointed out.

In health insurance coverage, Lee proposed to expand subsidies for disaster medical expenses and turn some non-insured items into insured ones, the group said. However, he showed limitations by failing to present a target coverage rate and ceiling on maximum medical expenses, it added.

The federation termed Lee a “worrisome candidate” because he pushes for commercializing the medical service.

Lee opposed the establishment of for-profit hospitals but agreed to that of for-profit subsidiaries of the existing hospitals. Besides, he promised to simplify procedures for applying for indemnity insurance, reinvigorate deregulation, make it easier for evaluating new medical technology, deregulate the use of private medical information, and revitalize telemedicine.

“Lee’s deregulatory platform threatens patients’ lives and safety for corporate profiteering,” the federation said. “In general, he put forth reform promises, but that was not enough. He is the worrisome candidate who put medical commercialization ahead of other things.”

Candidate Ahn also received an unfavorable evaluation, described as a candidate who will replenish the medical workforce but lacks details to put it into action. In addition, Ahn’s agreement on deregulating the biotech industry also marked his scores down.

Ahn has expressed willingness to secure a public hospital in each midsize medical sphere. However, the federation said Ahn’s intention was unclear because he attached a precondition to replenishing the medical workforce.

“In replenishing doctors and nurses, candidate Ahn pledged to do so gradually through consultations with professional groups, but that would get nowhere in reality,” it said.

The center-of-right candidate’s pledge to cover 90 percent of mental health treatments, abolish support for medical benefits, establish public postnatal care centers at a half cost, and expand nursing and care services received positive ratings.

However, the evaluator pointed out that Ahn supports for-profit hospitals and negative deregulation and puts too much emphasis on the biotech industry’s promotion, making clear his intention to commercialize the healthcare industry.

Yoon of the right-wing PPP marked the lowest score by failing to promise to increase public hospitals while expressing an intention to expand the private medical market.

“Candidate Yoon said he would solve the problems by increasing beds and financial rewards to private hospitals,” the federation said. “However, as everybody could see in the Covid-19 pandemic, the nation cannot respond to infectious disease disaster with private hospitals.”

Besides, Yoon’s pledge to entrust public health service to private hospitals to solve regional medical imbalance and the shortage of essential care also received poor marks. They could even aggravate the already poor treatment of vulnerable classes, hurting the public nature of medical service.

The group noted that Yoon made some positive promises, such as expanding disaster medical expense support, expanding the Korean version of sickness and injury allowance, introducing the family doctor system, integrating nursing and caring services, and covering costs at care hospitals. However, it pointed out that the conservative candidate would push for commercializing health services by supporting for-profit hospitals and expanding telemedicine.

“Candidate Yoon virtually agrees to for-profit hospitals, expanding pilot programs for telemedicine, and negative deregulation,” the federation said. “Given these policies, candidate Yoon is regarded as a candidate who retreats the public nature of medical services and further threatens the lives and health of the public in the pandemic era.”