The Problems of Establishing Health Subcenters in Urban Areas

Ji, Young Geon

Abstract

Since the implementation of the national medical insurance service in 1979, it has become necessary to reconsider medical services from the geographical point of view. As more medical professionals have been concentrated in the metropolitan and urban areas, publicly hired medical practitioners have been appointed to less populated regions (e.g., farms and fisheries) and public medical service has been reinforced. During the past 10 years, the government and the ruling parties have been dragged around by strikes and collective actions of medical organizations, who have been rather dissatisfied with the new policy, namely, the separation of dispensary from medical practice. In an attempt to hold such efforts into check, the government, who has lost its "pride as a leftist," saw the needs to implement the public medical service. Consequently, new regulations were focused on the expansion of both the quantity and shares in the medical service market of the public medical service, which can be directly controlled. The government has either misunderstood the needs for urban public medical service or diverted its underlying principles. Despite some studies that reported the financial loss of urban public medical service as unavoidable, the government established seven exemplary public medical services in November 2005. The inefficiencies of such medical service were first brought to the public attention by the municipal congress of Cheonan City. Moreover, there have been some cases of distorted medical practices in the Seoul area, caused by efforts to record amplified hours of services. Owing to the financial loss and lack of effectiveness of the public medical service, such wrongful actions have been well expected. The government should first institute the underlying concepts of public medical service. The current inefficient public medical service should be scrapped, if the purpose of such service is a "public service," per se. If the public medical service only fills blanks left out by private medical service, the current public institutions have to carry out their responsibilities. The needs for current public medical service should be addressed if the quality and details of such service is to remain inferior to private medical service and keeps wasting tax.