Healing South Korea’s Healthcare System

Anna Kim, Mar 13, 2024

37% of all South Korean doctors have gathered in Seoul in preparation to resign, threatening to cripple the country’s healthcare system in protest of a recently announced government initiative set to increase the cap on medical student admissions starting in 2025. Though ongoing, the strikes are indicative of much larger problems within the South Korean labor system stemming from intense nationalism and the culture’s destructive glorification of work ethic. Considering the government’s ongoing lack of support for workers’ rights–reflected by the current medical protests, lack of support for labor unions, and plummeting birth rates–it is in the South Korean government’s best interest to facilitate a true working-class trade union through solidarity with ongoing social movements. In the short term, eliminating criminal punishment as a response to workers’ strikes and reallocating funds within the medical sector to improve the pre-existing system may provide an effective solution to the walkouts. 


Shifting the government’s focus to hospital workers' rights has become increasingly necessary as medical personnel prepare to resign. Accounting for almost two-fifths of all total doctors in South Korea, the mass resignation threatened by 2,700 interns and residents from five of Korea’s major general hospitals would be a catastrophe for the country’s medical system which depends on them for both primary and secondary healthcare. South Korea currently possesses one of the lowest ratios of doctors to population in the developed world (2.6 doctors to every 1000 people) and the government has responded by proposing a 2,000-slot increase to the current 3,000-student cap at medical universities to address recent voter complaints directed towards long waiting times and inconsistent access to care. South Korean Prime Minister Han Duck-Soo claims that the vacuum in healthcare will “take the lives and health of the people hostage” [1] and further frustrate the already dissatisfied public, while doctors argue that such an increase is unmanageable and would only worsen the finances of the national health insurance plan [2]. South Korea’s nationalist capitalism is partially to blame, with a work-centric culture pushing employees of all occupations to a breaking point in an effort to best contribute to their country. This is reflected in South Korea’s notoriously high suicide rate–26 deaths per 100,000 people, almost double that of the United States–and the plummeting birth rates that initially incited the government’s scramble for medical students meant to supplement the predicted shortfall of 15,000 doctors by the year 2035 [3]. 


To alleviate the pressing systemic issues within the medical industry that doctors claim would be aggravated by the student expansion plan, redistribution of finances could act as a short-term solution. South Korea’s medical system is currently grappling with the strain of overburdened teaching hospitals and a lack of financial incentives for doctors to practice in crucial but unpopular medical sectors, such as obstetrics and pediatrics [4]. Meanwhile, hospitals outside of urban population centers continue to face supply and personnel shortages. Shifting finances into these essential specialties and expanding the current healthcare network, rather than forcing more students into an already congested system, may be the most effective short-term solution to managing the medical strikes while temporarily addressing the systemic issues mentioned above. In the long term, improvements to hospital workers’ rights will be necessary to prevent more walkouts that would devastate South Korea’s fragile healthcare structure.


On the national scale, South Korean trade unions have historically experienced very little success in government negotiations due to restrictions on appealable topics and a lack of industry support. On July 13, 2023, over 64,000 members of the Korean Health and Medical Workers Union (KMHU) began to strike alongside the Korean Confederation of Trade Unions (KCTU) in an attempt to engage the government after failure to implement agreed-upon concessions from their 2021 negotiations with the Ministry of Health and Welfare [5]. Known as the September 2nd Agreement, the concessions aimed to address systemic deficiencies within South Korea’s healthcare system that relied heavily on workers’ financial and temporal sacrifice. The government deemed the strike illegal under the second and third articles of Korea’s Trade Union and Labour Relations Adjustment Act (Trade Union Act), which classifies collective action–or “industrial action”–as illicit due to its obstruction of the normal operations of a business. Compliance with the TUA while participating in any form of labor protest is therefore near impossible. Lawsuits against workers are a common response to walkouts, with employers demanding that employees reimburse their financial losses and the state often requiring compensation for the costs of policing the strike. This can result in billions of won worth of debt–a crippling amount for a country whose average salary is around 3.8 million won per month [6]. The ineffectiveness of KCTU and FKTU (Federation of Korean Trade Unions–South Korea’s second umbrella labor union) due to governmental repression is evident in their membership; as of 2022, only 13.1% of workers were in trade unions–a 1.1% drop from 2021 [7].


Complicating the situation is the gradual increase of public opposition against the labor movement, in part due to cultural conservatism and South Korea’s rapid globalization, which have villainized any factor that slows economic growth [8]. Therefore, it may be in the unions’ best interest to continue campaigning against the second and third articles of the Trade Union Act while demonstrating solidarity between themselves by aligning with already-existing social movements within South Korea, which include the ongoing environmental protection and feminist movements. Alongside campaigns such as the recently–and controversially–vetoed “yellow envelope bill”, which aimed at limiting companies from making claims for damages against legitimate labor disputes, alignment with larger, more public movements would bring together the politically isolated trade unions and the general population [9]. Defrosting strained government-labor relations through appeals to the public mindset is the first step towards expanding workers’ rights and establishing a system that prioritizes the laborer, not the corporation.


The implementation of these policy amendments would also help to address other national issues, such as the birth rate and suicide rate crises mentioned earlier. Linked to anxiety over employment, housing, and childcare, guaranteeing fairer working conditions for laborers may alleviate women’s concerns surrounding career advancement and the financial stress of raising a child. Suicide rates have similarly been associated with financial struggles and cutthroat Korean work culture – two symptoms of workplace inequality that could be addressed by strengthening employee rights. 


The potential economic benefits are also significant. With 60% of Korean households earning a monthly income less than one million won (approximately 750 USD) above the national minimum wage, more robust unions encourage higher wages and increased benefits pivotal to building a solid middle class [10]. By reducing income inequality, unions spur the national economy by placing money in the hands of those most likely to spend it–South Korea’s middle class. Through governmental support for workers’ rights, South Korea could mitigate issues such as the recent medical protests while addressing the deeper cultural issues within the nation’s labor system, paving the way for future generations to work in a healthier, more equitable environment that focuses on the promotion of a higher quality of life.


[1] Kim, Jack. “South Korea PM Asks Doctors Not to Quit over Planned Medical Student ...” Reuters, February 17th, 2024. https://www.reuters.com/world/asia-pacific/south-korea-pm-asks-doctors-not-quit-over-planned-medical-student-increase-2024-02-18/.

[2] Young, Jin Yu. “South Korean Doctors Walk out, Protesting Plan to Increase Their Ranks.” The New York Times, February 20th, 2024. https://www.nytimes.com/2024/02/19/world/asia/south-korea-doctors.html.

[3] Subramaniam, Tara, and Yoonjung Seo. “Lee Sun-Kyun: Death of ‘parasite’ Star Puts Spotlight on Pressures Facing South Korean Celebrities.” CNN, December 29th, 2023. https://www.cnn.com/2023/12/29/asia/lee-sun-kyun-death-south-korea-celebrity-losses-analysis-intl-hnk/index.html#.

[4] Song, Jiwon. “South Korean Doctors Rally against Government Plans to Increase the Number of Medical Students.” ABC News, February 15th, 2024. https://abcnews.go.com/Health/wireStory/south-korean-doctors-rally-government-plans-increase-number-107255774.

[5] “Korean Health Workers’ Union Wins Eleventh-Hour Agreement, Halts General Strike.” UNI Global Union, February 7th, 2022. https://uniglobalunion.org/news/korean-health-workers-union-wins-eleventh-hour-agreement-halts-general-strike/.

[6] “Hankyoreh.” By blocking union bill, Yoon further strains government-labor relations, December 4th, 2023.

[7] Pro, Korea. “South Korea Sees Decline in Union Membership amid Confrontation with Government.” KOREA PRO, January 23rd, 2024. https://koreapro.org/2024/01/south-korea-sees-decline-in-union-membership-amid-confrontation-with-government/?t=1708394929959.

[8] Song, Ho Keun. “Labour Unions in the Republic of Korea: Challenge and Choice.” Seoul , October 7th, 1999.

[9] Kim, Han-Joo. “(3rd LD) Yoon Vetoes pro-Labor ‘Yellow Envelope Bill,’ Broadcasting Law Revisions.” Yonhap News Agency, December 1st, 2023. https://en.yna.co.kr/view/AEN20231201001653315.

[10] Lee, Sang-ryeol. The Shaky Korean Middle Class, May 18, 2023. https://koreajoongangdaily.joins.com/2023/05/18/opinion/columns/Korea-middle-class-economy/20230518195931732.html.