[Contribution] New government, same old healthcare problems?

A new government is about to be sworn in. I don't know who the next president will be, but I can’t help but wonder what the new Ministry of Health and Welfare will look like.

Some people, including many in the medical community, believe that health and welfare should be separated. Will that happen? I’ve always thought so myself. However, officials argue that creating another ministry is complicated. If welfare is merged with labor, they say, a new ministry may not even be necessary. Either way, the issue remains unresolved.

Most of the people who worked hard in the Yoon Suk Yeol administration will be heading home, and senior positions in the new government will likely be filled by political figures and former bureaucrats who were sidelined by the previous administration.

The incoming government may try to appease the medical community by bringing in figures like Jeong Eun-kyeong, former head of the Korea Disease Control and Prevention Agency (KDCA), who held high-level roles during the Moon Jae-in administration. However, that seems unlikely if Lee Jae-myung becomes president.

The next health and welfare minister will face a long to-do list. The immediate challenges -- reinstating resigned trainee doctors and handling medical students on leave -- will already be complicated enough.

On top of that comes the broader issue of healthcare reform.

Many believe the reform efforts of the Yoon administration will be completely scrapped under a new government. I don’t think so.

Aside from the plan to increase medical school admissions by 2,000, the four key reforms should be seen as initiatives of the Ministry of Health and Welfare -- not the Presidential Office. In other words, even with a change in leadership, the ministry is likely to continue pushing forward with the same policies, only repackaged in a new envelope.

However, if public healthcare expansion and the creation of public medical schools are added to the mix, the situation will become even more difficult. Tying these contentious issues to an already complicated landscape won’t offer any real solutions.

That means the next minister and senior officials must be both brilliant and politically savvy. But such people are hard to find.

If the new administration doesn’t demonstrate a clear will to resolve the medical crisis left by the Yoon government, the turmoil will likely continue. Medical schools are frustrated, and although hospitals are still running, they are not functioning at full capacity.

Suppose the new government sees no urgent crisis—even if trainee doctors don’t return. Will it respond by giving the medical community the answers it wants, even if that means conceding to all their demands?

I don’t think so. The Ministry of Health and Welfare is unlikely to request such action from the new president, either. New ministry leaders may well say, “Why should we fix what the previous team messed up?”

What if they simply blame the previous administration and drag their feet?

Some in the medical community are clinging to their current position, holding out hope that the next government will take their side. In short, that’s wishful thinking.

As I’ve said before, our healthcare system is far beyond the point of minor fixes. It’s burdened by an excessive focus on the Seoul metro region, a broken delivery system, and a deeply entrenched unreimbursed care structure. None of that will be resolved with one or two changes. We need a complete overhaul -- and I don’t know if the next administration will be up to the task.

If the new leadership remains stuck on expanding public healthcare and believes that alone will solve everything, there’s not much to look forward to.

The medical community will likely threaten to strike again in opposition to policies aimed at expanding public healthcare and creating new public medical schools—though I’m not sure they can afford to take such action right now.

At the very least, the medical community must stay vigilant—but even that may be too much to expect.

One way or another, the outlook is grim. At this point, debates over returning trainee doctors or reinstating medical students seem secondary to the deeper, systemic issues we face.