Measures urgently needed to address disparities in medical access

Seventeen hospitals in Korea were ranked as the World's Best Hospitals in a hospital evaluation conducted by Newsweek. However, the fact that all the hospitals, except for Daegu Catholic University Hospital, were those in the Seoul Metropolitan Area, including Asan Medical Center and Samsung Seoul Hospital, reflects the lack of medical care access in rural areas. The ranking, conducted annually since 2019, consists of quantitative indicators such as patient-to-doctor ratio as well as qualitative indicators such as patient satisfaction.

Local hospitals are suffering from chronic deficits and a shortage of doctors due to population decline and the concentration of patients in the Seoul metropolitan area. When these hospitals close, these patients have no choice but to travel to Seoul, widening the medical gap between urban and rural areas. As of 2021, the number of ‘treatable deaths’ per 100,000 population owning to timely treatment was 38.6 in Seoul, but 49.6 in Gangwon.

The government, however, has neglected the situation. Public hospitals should take over the role of private hospitals when they close due to poor profit, but public hospitals in Korea account for only 5% of hospitals. No investment was made in resources or finances. In Japan, seven out of the 15 best hospitals in the world were hospitals outside of concentrated urban areas, including Kyushu University Hospital, Nagoya University Hospital, and Kyoto University Hospital. It resulted from consistent resource and financial investment, including policies that encourage doctors to commit and practice in medically vulnerable areas and fostering local national university hospitals backed by funds to promote local medical care.

The government vowed to promote essential medical care in remote areas by expanding the medical school quota by 2,000 students every year for five years. However, a concentration of doctors in the metropolitan area will only increase the burden on the public, including a sharp increase in medical expenses, which is not the desired goal. The government is planning to implement policies to allocate medical doctor resources in rural locations and guarantee professor recruitment and income. However, it is still questionable whether these policies alone will address the imbalance without other means of bold support, such as a medical fee system applicable to rural areas. Today, people's rights to medical care vary depending on where they live, which is abnormal. Effective measures must be taken to ensure that the increase in medical school quota addresses disparities in access to medical care.