Lee calls for rationalized medical fee system, stronger government role in public healthcare

President Lee Jae Myung said Wednesday that rationalizing the medical fee system is a priority in addressing gaps in regional, essential and public healthcare.

Speaking at a forum on regional, essential and public healthcare held that afternoon at the Yeongbingwan reception hall of Cheong Wa Dae, Lee said the shortfalls that have emerged in public, essential and regional medicine are "strongly economic in nature."

He questioned whether medical fees are being set properly and said expanding public healthcare would require the state to take on a clearer share of responsibility. "I have come to wonder whether it is truly effective to leave all of this — medicine — in the realm of individual profit-making and then demand moral and public accountability from it," he said.

Lee also addressed the government's role directly. "On the issues of public and essential healthcare, we are continuing to review policy in the direction of strengthening government responsibility," he said. "In regional healthcare as well, both demand and supply are concentrating in one place. I believe solving that, too, will ultimately be possible by strengthening the public role."

Lee also cited progress on healthcare reform, including the expansion of medical school enrollment.

He began by crediting the medical community for South Korea's healthcare system, which he described as among the most exemplary in the world. "I believe the greatest contribution has come from South Korea's medical professionals," he said. "Their overall dedication — their unwavering love and commitment to patients even in difficult conditions — has accounted for the largest share."

He added that despite a period of turbulence in the healthcare system, reform had proceeded without major disruption. "Our citizens may well be wondering, 'When did things get so quiet?' — that is how smoothly the necessary healthcare reforms are moving forward," he said. "The significant progress made on the medical school enrollment issue and on securing public, regional and essential healthcare — both important parts of healthcare reform — is a very welcome and meaningful achievement."

Lee also drew on his experience as a lawyer handling lawsuits against obstetricians, saying doctors must have the basic conditions in place to fulfill their duty of care.

Recalling those cases, Lee said he had thought at the time, "I'd understand if someone didn't want to work in obstetrics after going through this" — and that the prediction had come true over the following decade or more. "I hear that obstetricians these days are trying to avoid doing deliveries," he said. "The thought that came to me then was: 'Even as I argue in court for a doctor's negligence, are the basic conditions needed to meet that duty of care actually in place? I don't think they are.'"

He added that he had once wondered whether the state, rather than individual doctors, should bear liability in such cases. "Because of that experience, I understand to a considerable degree the feelings of frontline medical professionals who want to avoid these high-risk areas," he said.

Lee also highlighted the importance of healthcare as a condition for settlement and balanced regional development. "When we ask what living conditions we need to create in the regions for them to develop, attract industry and achieve balanced growth, healthcare is said to be one of the most important objective factors," he said. "Improving the healthcare environment is therefore a core element — both for balanced regional development and for improving the conditions that make people want to live in the regions."

Lee encouraged participants to share their views, saying he hoped the government would reflect frontline voices as fully as possible in crafting healthcare policy that is "rational, achievable and oriented toward strengthening public responsibility."