04/02 (Tue.) The 2024 South Korean doctors’ strike (Host: Sherry)

[Sherry Liao]

Dear YOYOs,

Last month, South Korea doctors went on strike to protest the government's plans to increase 2,000 medical school students per year - a 65% increase on the current yearly enrollment of 3,058 students. Thousands of junior doctors, including interns and residents, went on strike, causing surgeries to be delayed and hospitals to turn away patients. As of today, the strike is still ongoing.

The South Korean government claims the plans is to address the shortage of doctors in critical areas. According to the data from the Organization for Economic Co-operation and Development (OECD), there are currently only 2.5 doctors per 1,000 people in South Korea - the second lowest rate in the OECD group of nations after Mexico.

But doctors claim that the manpower shortage in these places is not due to insufficient numbers, but rather to inadequate medical resources and treatment in these places that made it difficult to retain staff there. They call for improvements to pay and working conditions.

The South Korean government has begun taking steps to suspend the medical licenses of thousands of striking junior doctors, days after they missed a government-set deadline to end their joint walkouts. But the strike appears to be getting worse. As of March 8, 11,994 striking doctors, who make up 92.9% of the trainee workforce, have not yet returned to work. On March 25, medical professors began cutting back on the hours spent in practice in support of the ongoing strike.

Which side are you on? Please join us next Tuesday and let us know what you have to say!

Reference:
1. South Korea’s doctors on the brink with strike over enrollment surge plans | KOREA PRO
2. South Korean doctors strike in protest of plans to add more physicians | BBC News
3. South Korea strike: Thousands of junior doctors face suspensions | AP News
4. South Korea doctors’ strike widens as medical professors join protests | The Guardian

Questions for Discussion
Session I
Q1. The South Korean doctors have been on strike for more than a month, and the situation seems to be getting worse. What do you think are the main reasons why young doctors risk facing license suspensions by going on strike? Why do senior doctors and medical professors support them?

Q2. Public surveys show that a majority of South Koreans support the government’s policy to create more doctors. What are the possible reasons for that?
(Note: A Gallup Korea poll on Feb 16 showed that about 76% of respondents supported the policy of increasing medical school admissions. Another survey released by the Yonhap News Agency (韓聯社) on March 5 showed that 84% of respondents supported increasing the number of doctors, while 43% said striking doctors should be severely punished.)

Q3. Why is the government determined to implement the policy to increase medical school students? Do you think the South Korean government's response to the doctors' strike is justified or disproportionate? Is there anything the South Korean government could have done differently to avoid the doctors' strike?

Q4. A member of the Korea Severe Disease Association said that the government and the doctors are "fighting on the bodies of dying patients". What do you think? Which side are you on, the government or the striking doctors?

Session II
Q5. Some say doctors' strikes are immoral and quote the famous Declaration of Geneva, which states that as a member of the medical profession "the health and well-being of my patient will be my first consideration." What to you think? Do you agree that in a democracy, the right to strike should be available in any profession?

Q6. Should the medical school enrollment quota be limited? How should these be balanced against the need for accessible and high-quality healthcare?

Q7. What do you think the final outcome of this strike will be? Who will give in, the South Korean government or the striking doctors? What would be the effects if the South Korean government proceeded to suspend the licenses of all 9,000 doctors who went on strike?

Q8. Does increasing the number of medical students solves the problem of doctor shortage? As the protesting doctors say, many doctors have moved on to the more profitable fields of plastic surgery and dermatology. When the medical industry has become a free market, how does the government address the shortage of doctors in essential yet lower-paying areas like paediatrics and obstetrics, and in rural regions outside the greater capital area as the population ages?

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Agenda:
6:45 ~ 7:00pm Greetings & Free Talk / Ordering Beverage or Meal / Getting Newcomer’s Information
7:00 ~ 7:10pm Opening Remarks / Newcomer’s Self-introduction / Grouping
(Session I)
7:10 ~ 7:45pm Discussion Session (35 mins)
7:45 ~ 8:00pm Summarization (15 mins)
8:00 ~ 8:05pm Regrouping / Instruction Giving / Taking a 5 Minutes Break (Intermission)
(Session II)
8:05 ~ 8:40pm Discussion Session (35 mins)
8:40 ~ 8:55pm Summarization (15 mins)
8:55 ~ 9:00pm Concluding Remarks / Announcements

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Meeting Date: As shown on the Subject Line
Meeting Time: 7:00pm – 9:00pm
Meeting Venue: 丹堤咖啡 Dante Coffee (Minimum Order $85)
Address: 台北市濟南路三段25號[MAP]-捷運忠孝新生站3號出口步行3分鐘

Important Notes:
1. We advise participants to print out the discussion questions and bring them to the meeting for reference. As for the supporting articles, feel free to print them out, as well, according to your preference.
2. We suggest that participants read the articles and think about the questions in advance.
3. Newcomers should prepare a two-to-three minute self-introduction in English to deliver when called upon by the host before the start of the discussion. The host may also ask you to give brief feedback about the meeting at the conclusion of the meeting.
4. We conduct the entire meeting in English. All participants should have at least moderate English-conversation skills and be able to articulate your ideas for each discussion question.
5. We welcome newcomers and other guests to attend the meetings and join the discussion freely for two times. After that, we hope you will consider becoming a YoYo English Club member. We charge a NT$1500 lifetime membership fee, or NT$1000 for students.

[Rock]

The business is so good thanks to their system and their protectors. But why can they be exampted from the free market of supply and demand? Why do most of us, as patients, have to agree that there should be fewer doctors on the market so we have to pay more?



在自由民主的社會裡，各行各業依市場機制發展，基本上政府是不會也不應該介入的，但是還是有部分工作的人數會依社會需求而加以管制...
除了軍公教之外，還有一個行業，在世界各國也都同樣被管制的，那就是醫生的數量，管制的方法是...
https://vocus.cc/article/62cec049fd8978000123edfc


解決國內醫師荒，衛生福利部出手，擬於明年起，將現有的公費醫學生再增加一倍，由100名增加至200名。但中華民國醫師公會全國聯合會跳出來反對，強調台灣醫師人力...
https://tw.sports.yahoo.com/news/%E5%85 ... 00820.html

[Sherry Liao]

The business is so good thanks to their system and their protectors. But why can they be exampted from the free market of supply and demand? Why do most of us, as patients, have to agree that there should be fewer doctors on the market so we have to pay more?

Although the following article does not directly answer your question (in fact, I don’t have an answer in my mind), I think this old article raises another point of view, which is also worth reading:

1. 醫師總量管制的主因：醫師人數增加，會誘發醫療需求增加
醫學院畢業生應該還記得公衛老師曾提過，各國會管制醫師人數，是因為醫師人數增加，會誘發醫療需求增加。這叫做Supplier Induced Demand，或叫做Physician-Induced Demand。

2. 總量管制第二因：醫療必須高度管制，不能「自由競爭」
台灣人常忽略的是：醫療行為不能以「市場力量」、「自由經濟」來看待。醫療行為絕對不是業者與消費者的關係。
https://article.denniswave.com/7472/

[Rock]

...醫療行為絕對不是業者與消費者的關係。
https://article.denniswave.com/7472/

中文蠻有趣。上面那句跟「醫療行為不絕對是業者與消費者的關係。」意思一樣嗎?

如果醫療行為絕對不是業者與消費者的關係，那應該是甚麼關係?

所謂的「醫病關係」如果是國家該高度介入管理以保障人民健康與生命的業務，那麼，國家應該做到那些事？

"Chinese is quite interesting. Does the previous sentence mean the same as 'Medical behavior is not purely a relationship between providers and consumers'?

If medical behavior is absolutely not a relationship between providers and consumers, then what kind of relationship should it be?

If the so-called 'doctor-patient relationship' is a business that the state should heavily regulate to safeguard the health and lives of the people, then what should the state do?"

The English part is translated by chatGPT.

[Luis Ko]

If the relationship between doctors and patients is not "supply and demand", why there's "supply induced demands" problem!? Very interesting topic. I will try my best to be there.

[miller]

Move to the top.

[Iris Wu]

In my opinion, it's common sense: medical behavior should NOT be viewed as merely a provider-consumer relationship. Rather, it should be considered a “highly regulated business.” Essentials for survival should not be subject to the pure forces of demand and supply, nor should they be determined solely by the market.

Take the example of electricity, a necessity for the majority, such as businesses similar to Taipower. What would happen if it were purely governed by market forces without any regulations? Recall the Enron scandal in the early 2000s? The open-market electricity in California was manipulated by a power supplier in Texas, impacting the lives and expenses of millions. The execution of 'Demand and Supply' is easily manipulated. Without regulations, medical practices would expose people's lives to the impulses of capitalism.

I don’t mean to suggest that scandals are impossible with regulations in place. Regulation bodies are supposedly above politics. However, I'm not sure how sound and effective this kind of organization is in Taiwan.

[Sherry Liao]

...醫療行為絕對不是業者與消費者的關係。
https://article.denniswave.com/7472/

中文蠻有趣。上面那句跟「醫療行為不絕對是業者與消費者的關係。」意思一樣嗎?

如果醫療行為絕對不是業者與消費者的關係，那應該是甚麼關係?

所謂的「醫病關係」如果是國家該高度介入管理以保障人民健康與生命的業務，那麼，國家應該做到那些事？

"Chinese is quite interesting. Does the previous sentence mean the same as 'Medical behavior is not purely a relationship between providers and consumers'?

If medical behavior is absolutely not a relationship between providers and consumers, then what kind of relationship should it be?

If the so-called 'doctor-patient relationship' is a business that the state should heavily regulate to safeguard the health and lives of the people, then what should the state do?"

The English part is translated by chatGPT.

The relationship between doctors and patients is complex and multi-faceted. While there are certainly elements of supply and demand at play, there are also other factors that can influence the dynamics of this relationship. One such factor is the concept of trust, respect, communication, and a common understanding of both the doctor and patients’ sides.

As for the role of the state in regulating the doctor-patient relationship, this can vary depending on the specific laws and regulations of the state in question. In general, physicians should consult with their local medical boards to determine the law for their particular state. The state may have a role in ensuring that the relationship between doctors and patients is conducted in an ethical and professional manner, and that the rights and well-being of patients are protected. However, the specifics of how this is achieved can vary depending on the state and the specific circumstances.
-------------

Please ignore it! It was made by Copilot

「醫療行為絕對不是業者與消費者的關係」 和「醫療行為不絕對是業者與消費者的關係」意思當然不同，如果我的中文學得正確的話

但這二句話我其實更同意後者，想想醫美及目前醫療市場上許多自費的治療項目，我覺得更像是自由市場中業者與消費者的關係

[Sherry Liao]

If the relationship between doctors and patients is not "supply and demand", why there's "supply induced demands" problem!? Very interesting topic. I will try my best to be there.

Thanks! Hope you can make it there for the discussion!

[Sherry Liao]

In my opinion, it's common sense: medical behavior should NOT be viewed as merely a provider-consumer relationship. Rather, it should be considered a “highly regulated business.” Essentials for survival should not be subject to the pure forces of demand and supply, nor should they be determined solely by the market.

Take the example of electricity, a necessity for the majority, such as businesses similar to Taipower. What would happen if it were purely governed by market forces without any regulations? Recall the Enron scandal in the early 2000s? The open-market electricity in California was manipulated by a power supplier in Texas, impacting the lives and expenses of millions. The execution of 'Demand and Supply' is easily manipulated. Without regulations, medical practices would expose people's lives to the impulses of capitalism.

I don’t mean to suggest that scandals are impossible with regulations in place. Regulation bodies are supposedly above politics. However, I'm not sure how sound and effective this kind of organization is in Taiwan.

I agree that medical behavior should also be considered a “highly regulated business.” However, should the rights and well-being of patients always be prioritized over the rights of medical staff? If not, how do regulators balance this? That is a question.

[Iris Wu]

A regulated business is still a business. It’s just the profit of this business is regulated, usually it has certain markups, but not purely decided by the market.

As far as the wellbeing of patients and medical stuff priority is concerned, I think they both are covered under the big umbrella of “human rights”. We do have ethical dilemmas in healthcare systems to achieve both perfectly, but just like many systems in human societies, it’s not the matter of whose wellbeing has priority but rather how to establish a functionally effective system for both patients and medical staff. Above all, medical staff could become patients someday.

I am sure there are existing cases in many regulated businesses. Can workers of power companies strike to stop repairs of power supply for emergency usage? If not, how do we regulate it? I think both sides usually do some scenarios planning to arrange the least impacts of protests. If either side does irrational actions, they will be viewed as acting without moral and ethical concerns.