Healthcare experts are paying attention to how East Germany and West Germany integrated their healthcare system, amid heightened anticipation for a reunified Korea after the inter-Korean summit last Friday.

Despite frequent exchanges in the healthcare sector before the reunification, Germany went through many difficulties in integrating medical workforce, a local report said.

According to the “Study on how to recognize North Korean defectors’ qualifications for healthcare experts,” released by the Korean Medical Association, East and West Germany integrated their healthcare system in two years after the reunification in 1990. However, the process has not been very smooth.

Before the reunification, East Germany had a socialist medical system where the state-owned clinics took care of all outpatient treatments. East German medical school education was also different from that of West Germany in that East Germany taught Marxism, Leninism, and Russian-language subjects in addition to medical education.

Just like in East Germany, North Korean medical schools reportedly teach political thoughts such as Kim Il-sungism, Kim Il-sung’s revolutionary activities, Kim Jong-il’s revolutionary activities, Juche (self-reliance) philosophy, Juche political economy, national reunification, South Korean Affairs, and the U.S. and Japanese imperialist invasion.

West Germany completely absorbed the healthcare system of East Germany. Educational institutions provided East German physicians with education on West German society, welfare, and administration. Under the reunification treaty, West Germany privatized East German medical institutions.

About 700 million Deutsche mark have been invested for seven years since 1995 to raise the level of East German medicine to that of West Germany.

In just four months after the reunification treaty, East Germany adopted Western German health insurance. It took less than two years to privatize the national healthcare system.

As East and West Germany had frequent exchanges in the medical sector before the reunification, the two Germanys were well aware of each other’s level. After the reunification, West Germany recognized East German medical license.

However, doctors from the two countries had different social status. East German physicians were middle-class, and there were many. On the other hand, West German physicians enjoyed the high social status, and medical schools accepted excellent students only.

Before the reunification, physician jobs were saturated in East Germany. The number of East German physicians has been increasing every year since the 1945 division. However, the figure temporarily declined after the collapse of the Berlin Wall in November 1989 because more than 10,000 East German doctors left poorly-equipped East Germany for West Germany. Germany was reunified in October 1990, about one year after the fall of the Berlin Wall.

To narrow the gap in medical care between East and West Germany, West German doctors’ groups and states formed sister states to hire West German doctors as executives at East German hospitals or had West German general hospital experts to work in East Germany temporarily.

East and German medical workers often did not get along very well. West German physicians accused their Eastern counterparts of lacking skills and providing inadequate medical care. East German doctors pointed out that West German physicians were only interested in making money.

Also, internal reforms of East German hospitals had many conflicts because West German staffs regarded Eastern workers as being rigid.

East German physicians were dissatisfied with the new medical system. There was a cost burden issue coming from purchasing new medical equipment and hiring employees. The confusion surrounding the need to deal with multiple insurers was significant.

“Before the 1945 division, Germany had a single medical education and medical license system. Despite the different medical education and medical license systems after the division, continuous medical exchanges made it possible to narrow the gaps and allow medical licenses to East German doctors,” the KMA’s report said.

It is particularly noteworthy that Germany put extra effort to provide supplementary measures to eliminate complaints from doctors from both sides after the reunification, it added.