Democratic Party of Korea candidate Lee Jae-myung has become the new president, marking the first change of government in three years.

As the election was held in the wake of the ouster of former President Yun Suk Yeol, Lee will begin his presidential term immediately after a brief inauguration ceremony at the National Assembly on Wednesday.

An urgent healthcare policy challenge facing the Lee Jae-myung administration is to resolve the government-doctor conflict over the Yoon administration's plan to increase the number of medical students by 2,000. If the prolonged conflict is resolved quickly and amicably, Lee's healthcare policy will gain momentum.

However, if the conflict persists, it will likely face difficulties from the start.

Medical students and trainee doctors have high expectations of the new government. Can they, however?

The key to resolving the conflict lies in the hands of medical students who left school to protest the increase in the medical school enrollment quota and trainee doctors who left hospitals. With the vast majority of medical students and trainee physicians still calling for the complete withdrawal of quota increases and other healthcare reform policies, the only way to bring them back is to accommodate their demands or offer alternatives to win them over.

According to the medical community, many medical students, interns, and residents believe Lee’s election could help them realize their cause.

Given Lee's campaign promises to resolve the conflict and push for healthcare reform, however, the outlook does not seem so rosy. Lee promised to establish a “People-Centered Healthcare Reform Discussion Committee” to promote real healthcare reform with the people, not seeking unilateral reform.

While one cannot know the specific composition of the committee and the content of the discussions, it is unlikely that all of the current medical students and junior doctors' demands will be accepted if the public and many neutral experts participate in the discussions instead of the new government conducting one-on-one negotiations with the medical community.

In the end, with the new government likely to take the “return after discussion” approach, the question is whether medical students and trainee doctors will trust President Lee Jae-myung and decide to return. Suppose the students and medical residents continue to insist on “returning after repealing quota increase and the healthcare reform” as they have done so far. In that case, the government-doctor conflict is more likely to continue even under the new government.

What about President Lee’s promised healthcare policy?

As a candidate, President Lee emphasized the expansion of “public healthcare” to restore regional and essential medical care. Accordingly, he announced his intention to establish a public medical school and an academy to train medical personnel. In particular, the academy will focus on building a system that encompasses the selection, education, training, deployment, and management of public medical personnel.

Given that the creation of public medical schools and a public medical academy are long-standing projects of the Democratic Party of Korea, they are likely to be expedited under the Lee administration as the symbols of his healthcare policy. The Yoon Suk Yeol administration's decision to increase the number of medical school students will also make it easier to secure an enrollment quota for a public medical school than under the Moon Jae-in administration.

However, the Lee Jae-myung administration’s healthcare policy is unlikely to deviate much from Yoon's healthcare reform, as the mainstream of the healthcare policy of expanding regional and essential medical care will not change.

President Lee and his party have promised to strengthen national responsibility for medical accidents in essential healthcare, strengthen national compensation for force majeure medical accidents, and strengthen the function of the Korea Medical Dispute Mediation and Arbitration Agency, all of which are included in the Yoon administration's healthcare reform agenda.

In addition, Lee also called for institutionalizing non-face-to-face medical treatment, establishing a public e-prescription transmission system, establishing a stable supply system for essential drugs, establishing a support system for innovative pharmaceutical companies, and strengthening the social responsibility of pharmaceutical companies, building infrastructure for the next pandemic and strengthening international cooperation, establishing a support system for medical science convergence to foster research experts for physician-scientists, expanding integrated nursing and caregiving services, applying health insurance for caregiving expenses, expanding home visits and home care by activating the personalized primary care system, expanding support for rare and incurable diseases, and implementing a national responsibility system for childhood obesity and diabetes.

However, all these should be seen as the result of adjusting policy priorities rather than discoveries by the Lee Jae-myung government.

How will the Lee administration continue Yoon’s healthcare reform?

Another reason why Lee Jae-myung's government may not be able to do much with Yoon's healthcare reform is that many of the big tasks for healthcare reform are already underway.

“The government continues even if the regime changes, so we cannot promise to change the things that have been promoted before because it is a matter of calling for wasteful debates and denying continuity of administration,” said Cho Won-joon, a senior expert member of the policy committee of the DPK, said at a meeting with journalists last Thursday.

Therefore, many of the healthcare reform projects already underway will continue under the new government.

They include supporting the restructuring of high-level general hospitals, increasing the number of over 1,000 life-threatening procedures, such as surgery and anesthesia, introducing a patient advocate system, expanding medical malpractice insurance deductions, building comprehensive secondary general hospitals, and providing selective insurance benefits. However, their details will be modified to dilute the color of the previous government.

On the other hand, the controversial but not yet fully implemented measures, including the introduction of medical licenses, the establishment of the Korean Accreditation Council for Graduate Medical Education (K-ACGME), and the restriction on unreimbursed treatment for beauty and cosmetic purposes and parallel medical treatment are expected to be reviewed and decided upon by the new government.

“The Ministry of Health and Welfare, like all other government agencies, must prepare a work report explaining its current policies and plans,” a ministry official told Korea Biomedical Review over the phone on Tuesday. “The policy issues and directions of the new government will come afterward, so we have no choice but to prepare a work report first.”