网友争论：韩国的医疗保健系统正处于崩溃边缘，“唯一在手术室内安装监控摄像头的国家”“，许多人选择了利润丰厚的整形外科”“缺乏愿意在儿科、耳鼻喉科等领域专业化的医生”
Korea's healthcare system is in verge of collapse.
译文简介
韩国的医疗保健系统正处于崩溃边缘，“唯一在手术室内安装监控摄像头的国家”“，许多人选择了利润丰厚的整形外科”“韩国目前缺乏愿意在儿科、耳鼻喉科等领域专业化的医生”“他们是韩国最高收入阶层，没有权利报怨”
正文翻译
正文
Korea's healthcare system is in verge of collapse.
I am a resident of South Korea. In Korea, you need to go through six years of medical school education, one year of internship, and 3-4 years of residency to become a specialist. There are no government subsidies for medical education. After becoming a specialist, most doctors do a two-year fellowship. And most doctors become specialists.
Resident can legally work up to 88 hours a week, and most work 80 hours a week and earn a little more than the minimum wage. The number of doctors produced per year is about 3,000 now, but the government is trying to increase the number of medical students to 5,000. Although there are fewer doctors than the OECD average, the rate of increase is already significantly higher, and access to healthcare is good. No one have to wait a day to see a specialist. All this is done at the expense of the youth of residents and fellows in college hospitals.
The main reason for increasing the number of doctors by 2,000 is that the president is trying to create a political reversal of approval ratings by attacking well-paid doctors. Some departments, including pediatrics, are in crisis due to the aging population, low birth rate, and increasing medical litigation, but the government is agitating that increasing the number of doctors will solve all problems.
The National Health Insurance is already on the verge of depletion due to the aging population. Many medical bills are below the cost. So hospitals prefer hiring PAs which are still illegal here. They even participate in surgeries. If the treatment does not meet the criteria set by the Korea Medicines Agency, it will be cut. Even unintentional medical negligence can result in criminal penalties and can be arrested by the prosecution. And Korea is the only country with surveillance cameras in operating rooms. Doctors have warned that they will go on strike, and the media and political circles have been constantly campaigning in recent months for news that doctors are too greedy. In reality, well-paid doctors are engaged in non-NHI services, such as cosmetic surgery and skin care.
Even in the first year of residency, a doctor's license may be revoked due to unintentional medical negligence. If you are sentenced to more than imprisonment for any kind of crime, your license will be revoked. All doctors are obligated to the NHI, and the cost of all essential medical practices is determined by the NHI. Even with all this, all the media have been treating us as criminals for months as greedy doctors.
Residents no longer find a reason to sacrifice more than 80 hours a week because the future will be dark. We are in a desperate situation.
韩国的医疗保健系统正处于崩溃边缘。
我是韩国人。在韩国，要成为一名专科医生，你需要完成六年医学院教育、一年实习期以及三至四年的住院医师培训。医学教育没有政府补贴。成为专科医生后，大多数医生还会进行为期两年的专科进修，并且大多数医生都会成为专科医生。
住院医师合法工作时间上限为每周88小时，而实际上大部分人都工作约80小时，收入仅比最低工资略高一些。目前韩国每年培养的医生数量约为3000人，但政府正试图将医学专业学生的数量增加到5000人。虽然相对于经合组织国家（OECD）平均水平，韩国医生人数较少，但增长速度已经显著提高，而且患者就医便捷度良好，无需等待即可看专科医生。这一切都是以大学医院里年轻住院医师和专科进修医生的青春为代价实现的。
政府计划增加2000名医生的主要原因在于总统试图通过攻击高薪医生来扭转其支持率下滑的政治局势。尽管一些科室，如儿科，由于人口老龄化、低生育率和医疗诉讼增多等原因面临危机，但政府却鼓吹增加医生数量可以解决所有问题。
由于老龄化进程加快，国民健康保险基金已濒临枯竭。许多医疗费用低于成本，因此医院更倾向于雇佣尚属非法的医疗助理（PA），甚至让他们参与手术。若治疗不符合韩国药品管理局设定的标准，则会被削减支付。即使非故意的医疗过失也可能导致刑事责任，被检方逮捕。韩国是唯一一个在手术室内安装监控摄像头的国家。医生们已发出警告称可能会举行罢工，而媒体与政界近几个月来持续报道，指责医生贪婪。实际上，高薪医生更多地从事非国民健康保险覆盖的服务，例如整形外科和皮肤护理等。
即使是住院医师的第一年，由于非故意的医疗过失，医生的行医执照也可能被吊销。对于任何犯罪行为被判刑超过监禁者，其行医执照也会被撤销。所有医生都必须遵守国民健康保险（NHI）规定，并且所有基本医疗服务的费用由国民健康保险（NHI）来决定。尽管如此，在过去的几个月里，媒体一直将我们当作贪婪的罪犯来对待。
由于未来形势堪忧，住院医师认为不再有理由每周工作需要超过80小时。我们正处于绝望的境地。
I am a resident of South Korea. In Korea, you need to go through six years of medical school education, one year of internship, and 3-4 years of residency to become a specialist. There are no government subsidies for medical education. After becoming a specialist, most doctors do a two-year fellowship. And most doctors become specialists.
Resident can legally work up to 88 hours a week, and most work 80 hours a week and earn a little more than the minimum wage. The number of doctors produced per year is about 3,000 now, but the government is trying to increase the number of medical students to 5,000. Although there are fewer doctors than the OECD average, the rate of increase is already significantly higher, and access to healthcare is good. No one have to wait a day to see a specialist. All this is done at the expense of the youth of residents and fellows in college hospitals.
The main reason for increasing the number of doctors by 2,000 is that the president is trying to create a political reversal of approval ratings by attacking well-paid doctors. Some departments, including pediatrics, are in crisis due to the aging population, low birth rate, and increasing medical litigation, but the government is agitating that increasing the number of doctors will solve all problems.
The National Health Insurance is already on the verge of depletion due to the aging population. Many medical bills are below the cost. So hospitals prefer hiring PAs which are still illegal here. They even participate in surgeries. If the treatment does not meet the criteria set by the Korea Medicines Agency, it will be cut. Even unintentional medical negligence can result in criminal penalties and can be arrested by the prosecution. And Korea is the only country with surveillance cameras in operating rooms. Doctors have warned that they will go on strike, and the media and political circles have been constantly campaigning in recent months for news that doctors are too greedy. In reality, well-paid doctors are engaged in non-NHI services, such as cosmetic surgery and skin care.
Even in the first year of residency, a doctor's license may be revoked due to unintentional medical negligence. If you are sentenced to more than imprisonment for any kind of crime, your license will be revoked. All doctors are obligated to the NHI, and the cost of all essential medical practices is determined by the NHI. Even with all this, all the media have been treating us as criminals for months as greedy doctors.
Residents no longer find a reason to sacrifice more than 80 hours a week because the future will be dark. We are in a desperate situation.
韩国的医疗保健系统正处于崩溃边缘。
我是韩国人。在韩国，要成为一名专科医生，你需要完成六年医学院教育、一年实习期以及三至四年的住院医师培训。医学教育没有政府补贴。成为专科医生后，大多数医生还会进行为期两年的专科进修，并且大多数医生都会成为专科医生。
住院医师合法工作时间上限为每周88小时，而实际上大部分人都工作约80小时，收入仅比最低工资略高一些。目前韩国每年培养的医生数量约为3000人，但政府正试图将医学专业学生的数量增加到5000人。虽然相对于经合组织国家（OECD）平均水平，韩国医生人数较少，但增长速度已经显著提高，而且患者就医便捷度良好，无需等待即可看专科医生。这一切都是以大学医院里年轻住院医师和专科进修医生的青春为代价实现的。
政府计划增加2000名医生的主要原因在于总统试图通过攻击高薪医生来扭转其支持率下滑的政治局势。尽管一些科室，如儿科，由于人口老龄化、低生育率和医疗诉讼增多等原因面临危机，但政府却鼓吹增加医生数量可以解决所有问题。
由于老龄化进程加快，国民健康保险基金已濒临枯竭。许多医疗费用低于成本，因此医院更倾向于雇佣尚属非法的医疗助理（PA），甚至让他们参与手术。若治疗不符合韩国药品管理局设定的标准，则会被削减支付。即使非故意的医疗过失也可能导致刑事责任，被检方逮捕。韩国是唯一一个在手术室内安装监控摄像头的国家。医生们已发出警告称可能会举行罢工，而媒体与政界近几个月来持续报道，指责医生贪婪。实际上，高薪医生更多地从事非国民健康保险覆盖的服务，例如整形外科和皮肤护理等。
即使是住院医师的第一年，由于非故意的医疗过失，医生的行医执照也可能被吊销。对于任何犯罪行为被判刑超过监禁者，其行医执照也会被撤销。所有医生都必须遵守国民健康保险（NHI）规定，并且所有基本医疗服务的费用由国民健康保险（NHI）来决定。尽管如此，在过去的几个月里，媒体一直将我们当作贪婪的罪犯来对待。
由于未来形势堪忧，住院医师认为不再有理由每周工作需要超过80小时。我们正处于绝望的境地。
评论翻译
很赞 ( 2 )
收藏
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
Korean doctors have been complaining about the public healthcare system for like 20 years. The underlying message is that "we are not getting paid enough and we want more privatization"
IMO They are one of the worst interest groups in Korea - lacking heroism and pro-social attitude conventionally associated with doctors, being very much of the creature of tiger mom education and the pursuit of status and money (often forced by greedy parents and family) rather than genuine professional calling.
There are countless stories of male doctors sexually harassing nurses and going to brothels in group. They often lack the mature view of the world beyond that of status hierarchy, being considered by the society as the cream of the society and "tier 1" marriage materials; as "those who made it." I remember there's a saying that doctors are "high schoolers with a scalpel" (메스 든 고딩)
TV show "Sky Castle," available on Netflix (which was massively popular in Korea), is the best portrait of this ill of the society lol
韩国医生们对于公共医疗体系的不满已经持续了大约20年。他们传达的核心意思是：“我们的收入不够，我们希望更多地引入私营化”。
在我看来，他们是韩国最糟糕的利益团体之一——缺乏传统上与医生联系在一起的英雄主义和社会责任感，很大程度上是父母家庭的教育以及对地位和金钱贪婪追求的产物，而非出于真正的职业使命感。
有无数关于男医生性骚扰护士和集体光顾妓院的故事。他们往往缺少超越社会地位层级之外的成熟世界观，被社会视为社会精英和“一流”婚配对象，即所谓的“成功人士”。我记得有个说法是，医生就是“拿着手术刀的高中生”（메스 든 고딩）。
在Netflix上可以观看的电视剧《天空之城》（Sky Castle），这部剧在韩国曾风靡一时，是对这种社会弊病的最佳写照，让人啼笑皆非。
And of course they're opposing increasing quota for medical schools, they don't want more competition.
当然他们会反对增加医学院的招生名额，因为他们不希望竞争加剧。
They know that if there is actual good competition, they're out of there lol
他们清楚如果有真正的激烈竞争，自己就可能被淘汰出局了。
To where? North Korea?
It's a bit difficult for Korean speaking doctors to practice out of country, unles they're willing to take a significant paycut.
去哪儿？去朝鲜吗？
对于韩国医生来说，除非愿意大幅降薪，否则在国外行医还是挺困难的。
More privatization? The privatization of hospitals is one of the reasons why the health care system of my country is getting worse, because what all hospital owners now care about is profit and that ruins everything for doctors, nurses and patients.
更多的私营化？医院的私营化正是我国医疗保健系统恶化的原因之一，因为现在所有医院老板关心的只是利润，这对医生、护士和患者来说是一场灾难。
Medicine is still one of the most complex professions which require ton of training and inherent capabilities. It's one thing to come down on the abuse of power by them but it's another to expect more future talent to be willing sacrifice for the sake of the greater good. Not enough incentive will lead to shortage. In the end, the people will suffer poorer healthcare.
医学仍然是最复杂且需要大量培训及内在能力的职业之一。对他们的权力滥用进行批评是一回事，但期待更多未来的人才为了更大的利益而做出牺牲是另一回事。激励不足会导致人才短缺，最终人们将承受更差的医疗服务。
Exactly. Imagine how much worse Korea's healthcare system would be if it didn't attract high performing students who want the money and prestige. That's how incentives work. High pay attracts the hardest working/most ambitious students, who deliver higher quality of care on average than some random shmuck who wins an "attend med school and become a surgeon" lottery.
确实如此。设想一下，如果韩国的医疗系统不能吸引那些追求金钱和地位的优秀学生，其状况将会糟糕多少倍。激励机制就是这样运作的：高薪酬能够吸引最勤奋、最具雄心壮志的学生，他们提供的医疗服务品质会高于那些通过偶然机会“上医学院并成为外科医生”而进入医疗行业的普通人。
I don't do anything related to healthcare and don't know much about it. From only reading this, I don't understand how the things listed mean that the healthcare system is "on the verge of collapse". Can someone explain it to me?
我不从事任何与医疗保健相关的工作，对此了解不多。仅从这篇帖子来看，我不明白列出的这些事情怎么就意味着医疗保健体系“濒临崩溃”。谁能帮我解释一下？
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
Because it really isn’t. I read through the thread and honestly a lot of things op is exaggerating. For example he said brain MRI would cost 800 dollars however I had one done and it was around 300 usd. Accountability for doctors is also not a bad thing. It’s the profession they chose, same goes for pilots and captains, if you make a mistake people’s life’s depend on it, you should be liable. From what I understand the government wants to increase the number of medical students, which means more competition to existing doctors. Not saying the don’t have rights to complain and honestly they should get paid much more than they do, but saying Korean medical system is on a verge of collapse is very very exaggerated
因为实际上并不是这样。我通读了整个讨论贴，说实话发帖人夸大了很多内容。例如，他提到脑部MRI要800美元，但我做过的费用大约是300美元。对医生问责也不是坏事，他们选择的职业关乎人们的生命安全，就像飞行员和船长一样，犯错误就应当承担责任。据我理解，政府希望增加医学生的数量，这意味着现有医生将面临更多竞争。我不是说他们没有权利抱怨，实际上他们的收入应该远高于当前平均水平，但说韩国医疗体系即将崩溃是非常夸张的说法。
They have no right to complain. They're the elite of society, fucking untouchable unless they screw up and kill somebody. They usurped the place the Scientist and Engineer should be occupying. No, they have no right to complain.
他们没有权利抱怨。他们是社会精英，除非犯下致命错误，否则地位不可撼动。他们抢占了本应属于科学家和工程师的位置，他们没资格抱怨。
Oh don’t get me wrong, they have no rights to complain about being prosecuted and held liable for their mistakes. I think some of the doctors who work in public hospitals, overworked and underpaid have rights to complain tho. Even then you are right they are better off than 99% of population. Who should definitely complain are nurses tho, and not only in Korea but all over the world, they are not getting paid enough for shit they have to do.
不要误解我的意思，他们确实没有权利对因自己的错误而受到起诉或追责进行抱怨。不过，我认为那些在公立医院工作、过度劳累且薪酬过低的医生是有理由抱怨的。即便如此，你所说的他们比99%的人过得更好是对的。真正该抱怨的是护士们，不仅在韩国，在全球范围内，她们所承担的工作强度与所得报酬严重不符。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
Another reason why the country desperately needs to increase the quota for medical students and why such a large population of the country has been treating the doctor's unx as greedy for obxting to it - nurses. A significant portion of nursing and other hospital staff are under such severe working conditions they would rather go to another country to work.
国家迫切需要增加医学生名额的另一个原因以及为什么很大一部分民众认为医生工会反对这一举措是贪婪行为——那就是护士。相当一部分护理人员和其他医院员工所处的工作条件极为艰苦，以至于他们宁愿去其他国家工作。
It is true that a specialist can earn more than $8000 a month, and that they earn much better than ordinary office workers in Korea.
That sounds awfully low. 1100만원/month as a specialist...
专科医生一个月能挣超过8000美元是真的，而且他们的收入远高于韩国普通的办公室职员。
听起来这个数字低得惊人……作为专科医生每月1100万韩元……
That is the lower limit. Many specialists earn much more.
这只是最低限度，许多专科医生赚得更多。
One thing I learned during the pandemic is that in first world countries when medical experts talk about collapse, they mean a point where you start to see decline in quality of care and health outcomes. Whereas when the general public hears "collapse" they imagine a situation like Gaza where you've got people being treated in parking garages without sanitation or medicine.
在疫情期间我学到的一件事是，在发达国家，当医学专家谈论“崩溃”时，他们指的是医疗服务质量和健康结果开始下降的那个节点。然而，普通公众听到“崩溃”这个词时，想象的却是像加沙地带那样，人们在没有卫生设施和药物的停车场接受治疗的情况。
So OP is saying residents are ridiculously overworked and hospitals resort to shady practices to alleviate the shortage of doctors...... but apparently increasing the number of doctors to directly address those issues is the worst thing ever?
所以原帖（OP）指出，住院医师的工作负担极其繁重，医院不得不采取一些不正当的做法来缓解医生短缺的问题……但奇怪的是，直接通过增加医生数量来解决这些问题却被认为是最糟糕的事情？
It's more complicated than just number of doctors. More doctors sound good in my opinion, but it aint gonna help if most of them end up doing non-NHI work.
For example, trauma surgeons have trouble finding positions after finishing residency. Because hospitals choose to employ the bare minimum and overwork the barebone staff and residents on a tight budget.
It is worthwhile to read columns and pieces written by Dr. Lee Guk Jong. Even a star surgeon, and a national hero like him gets overworked and ignored by higher-ups.
Not a single resident applied for pediatric at SNU hospital this year. Yet headline talk about super long waitlines at pediatrics for a 3 minute appointments. New doctors are flocking to fields like Orthopedic while avoiding fields like pediatrics.
The demographic issue is one factor, but this also has to do with how NHI payment system is screwed up. NHi covered fields are fixed with little payment per treatment, while nonNHI treatments are much more profitable.
That's why you end up with a doctor overworking having a series of 3 minute appointments, trying to sell nonNHI treatments. The NHI pays so little per treatment that hospitals choose to employ only a handful of doctors and minimum wage residents and overwork them with hundreds of 3 minute appointments to stay afloat.
Fields like orthopedic has a lot of non-NHi treatments options and plenty of potential customers- old folks with muscle, bone, joint problems.
There needs to be more public budget, and more better positiins for NHI-covered "essential fields".
The problem isn't lack of doctors. The problem is not enough doctors hired in certain fields.
More doctors along with better NHI payments can lead to more doctors being hired at hospitals.
Neither Moon or Yoon have the guts to increase National Health Care. Nobody likes paying more. It takes a lot of public budget to provide a good quality, accessible health care.
Dr. Lee guk Jong made a lot of public statements over the last years how the medical care reform is heading in the wrong direction. I think it might be a worthwhile read to read about how poorly supported his trauma emergency center was.
问题并不只是医生的数量那么简单。在我看来，增加医生数量听上去不错，但如果大部分新医生最终从事非国民健康保险（NHI）覆盖的工作，那么增加医生人数也无济于事。
例如，完成住院医师培训后的创伤外科医生往往难以找到职位，因为医院会选择用最少的人员配置，并让基本员工和预算紧张下的住院医师超负荷工作。
阅读李贵钟博士撰写的文章和专栏非常有价值，即使是像他这样的明星外科医生和民族英雄也会遭受过度劳累，并被上级忽视。
今年首尔国立大学医院没有一名住院医师申请儿科。然而，新闻标题却在谈论儿科长时间等待就诊，每次看诊只有短短3分钟时间。新医生纷纷涌向如骨科等专业领域，而避免儿科等专业。
人口结构问题是原因之一，但这也与国民健康保险支付系统存在的问题有关。国民健康保险（NHI）覆盖的诊疗项目固定且每项治疗的补偿很少，而非NHI治疗则利润丰厚得多。
这就导致医生超负荷工作，一连串进行3分钟的看诊，还试图推销非NHI治疗项目。由于NHI对每次治疗的支付额极低，医院只好只雇佣少数医生和拿最低工资的住院医师，并让他们处理数百次3分钟看诊以维持运营。
骨科等领域拥有大量非NHI治疗选项和大量的潜在客户——有肌肉、骨骼、关节问题的老年群体。
我们需要增加公共预算，并为NHI覆盖的“必需领域”提供更多的优质岗位。
问题不在于缺少医生，而是在某些特定领域内招聘到的医生不足。
同时提高NHI支付标准并增加医生数量，可以促使医院雇佣更多医生。
无论是文在寅总统还是尹锡悦，都没有胆量提高国家医疗保险支出。没有人喜欢多付钱。提供高质量、可及性好的医疗服务需要大量的公共预算支持。
过去几年里，李贵钟博士多次公开表示医疗保健改革的方向错误。了解他的创伤急救中心得到的支持有多么匮乏，可能会是一篇值得一读的内容。
Out of many replies here, this is the most spot on comment, imho.
在众多回复中，我认为这条评论最为准确到位。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
This person knows the Korean medical system.
这个人对韩国医疗体系很了解。
To put this into context, by super long waitlines what do you mean? Where I’m coming from we have to wait months for many checkups, for example in my case an ultra sound scanning, if you rely on gov provided healthcare system
要理解这个问题，所谓的“超级长等待时间”是什么意思？在我的国家，如果依赖政府提供的医疗服务系统，许多检查需要等待数月之久，例如我自己的超声波扫描就得等几个月。
yea I think you underestimate how hospitals and management work. They are not some altruistic organization. There is always tension between frontline staff and management.
If you really want to fix something, you need to look at the root causes. Increase med students > all good right? I bet a lot of those will have difficulty finding residency places and specialist jobs thereafter because there won't be follow up positions. They will go overseas or go in other industries. I think partly that is what the post is getting at.. I do admit this government (and I guess some previous governments) honestly are so short sighted. They will be terrible project managers.
I think increasing med students in principle is not a bad thing but it needs be followed up by broader systems change. Medical staff are human too. You put them all in a cage and ask them fight for positions.. sounds like perpetuating what's already a hypercompetitive environment worse. There are other ways of doing things...
Don't know why that post triggered so many people here. I think some are just jealous and angry with life in general. The kid jst seems like he/she is still at school and doesn't have much real world experience and is commenting based on things they see as potential problems, probably would take it with a grain of salt
是的，我认为你低估了医院和管理层的工作方式。它们并不是什么慈善组织，一线员工与管理层之间总是存在紧张关系。如果你想真正解决某个问题，就需要查找根本原因。增加医学生人数——一切都好吗？我敢打赌，其中很多人在完成学业后会发现很难找到住院医师职位和专科医生工作，因为没有相应的后续职位供他们选择。这些人可能会选择出国或转行到其他行业。我想这篇帖子部分是在表达这个观点……我承认本届政府（以及可能之前的一些政府）确实目光短浅，作为项目管理者的表现非常糟糕。
我认为原则上增加医学生数量不是坏事，但需要伴随更广泛的系统变革。医疗人员也是人，如果你把他们都关在一个笼子里竞争有限的职位，只会加剧已存在的过度竞争环境。解决问题还有其他方法……
不知道为什么这篇帖子在这里激起了这么多人的情绪。我觉得有些人只是出于嫉妒或者对生活普遍感到愤怒。这位发帖人看起来还在上学，没什么真实世界的经验，他们基于看到的潜在问题进行评论，可能我们需要带着批判性的眼光看待这些观点。
Similar to America, doctors want to have their cake and eat it too. They want lower working hrs but also the freedom to make as much money as possible with less competition. More residency slots means more competition.
类似于美国，医生希望鱼与熊掌兼得：既想要减少工作时间，又想在较少的竞争中获得尽可能多的收入。增加住院医师名额意味着更多竞争。
Although I am reading your thought, I don't agree to the title. You just explained why you had to pay more attention to the elections than studying. This government is just shit and screwing this country thanks to your and your fellows' choice.
虽然我理解了你的想法，但我并不赞同这个标题。你只是解释了为何你不得不比学习更加关注选举。正是因为你们和你同辈人的选择，导致了现在这个政府糟糕透顶，把国家搞得一团糟。
There are too many doctors so no one wants to be a doctor anymore? Sounds like an old Woody Allen joke.
The Korean Medical Association is one of the more extreme right-wing groups in Korean politics (not saying all doctors are ... but the industry association for doctors is quite extreme). They tend to declare "all out war" any time the government tries to make changes.
有太多医生所以没人愿意再当医生了吗？听起来像是伍迪·艾伦的一个老笑话。韩国医学会是韩国政治中较为极端右翼的团体之一（并非说所有医生都是如此，但医生行业的协会相当极端）。每当政府试图做出改变时，他们往往会宣布“全面战争”。
So you are saying being prosecuted for negligence is a bad thing?
所以你说因过失被起诉是一件坏事？
Healthcare regulations are strict to prevent a culture of tolerating negligence. Medical negligence in most country has severe consequences because it’s a primary root cause to patients dying.
It’s the same for lawyers who are regularly assessed on their conduct, if they say things that demean the legal practitioner or discredit the profession of legal representation, it undermines society’s trust in the legal institutions for justice.
Why should it be otherwise. It’s a high pressure environment where you should never be negligent, because people can die.
The reason the costs are determined by the NHI and why doctors are obligated to service is that the medical industry globally has a very old history of bullshit accounting to evade taxes and billing schemes. Wtf makes doctors magically have the trust that they will do what’s best for the patient rather than for their own financial interests.
My personal advice: if all this personally bothers you so extremely, then quit the industry for something else.
医疗监管严格，旨在防止形成对医疗过失的容忍文化。在大多数国家，医疗过失会带来严重后果，因为它往往是导致患者死亡的主要原因之一。
对于律师来说也同样，他们的行为经常受到评估，如果有言行贬低法律从业者或损害法律代理职业形象，就会削弱社会对法律机构的信任。
所以为什么医生应该例外呢？这是一个高压环境，在这里绝对不能有过失，因为关乎生死。
由国民健康保险确定费用的原因以及为何医生必须服务，是因为全球医疗行业有着悠久的逃税和计费欺诈历史。凭什么认为医生就能神奇地只为了病人的最佳利益而行动，而不是出于自身的经济利益？
我个人的建议是：如果这一切让你感到极其困扰，那就退出这个行业，去做点别的事情吧。
This guy is nuts. Doctors I know agree in private that the number of doctors needs to be increased. There is an issue where only doctors can open plastic surgery clinics and such, and that is the main road to make boatloads of cash. But more doctors will send more doctors down that road and the overflow will go into hospitals. It is basic economics.
And the drought of doctors is really severe. Considering that hospitals without a pediatrician will turn kids and babies away at the door, try finding an emergency pediatrician at 3 AM on Saturday. Heck even 3 AM of a weekday or on week-ends at all. I think only 2 hospitals in Seoul have one 24/7.
这家伙简直是疯了。我认识的医生私下都同意医生的数量需要增加。现在有个问题是只有医生才能开设整形外科诊所等，这是赚大钱的主要途径。但如果医生增多，将会有更多医生走向这条路，过剩的人才会进入医院工作。这是基本经济学原理。
医生短缺的问题确实非常严重。考虑到没有儿科医生的医院会直接拒绝接收儿童和婴儿，试想一下，在周六凌晨3点试图找一位急诊儿科医生有多么困难。实际上，即便是工作日的凌晨3点，或是周末任何时间，也很难找到。据我所知，首尔只有2家医院能提供全天候的儿科急诊服务。
People don't realize that the skill to become a good doctor is really fucking hard. You don't compensate enough for it, who the fuck is going to want to dedicate 10 years of their life for it?
人们没意识到成为一名好医生所需的技能是多么难培养。如果没有足够的补偿，谁愿意付出10年的时间去成为医生？
HMMm... apparently anyone with sufficient grades to get in. Only the candidates with the topest of top scores get in and the drop-out rate in medical school is astronomically low. There is no shortage of people wanting to be a doctor. And I am not saying it is easy or that we should let idiots do it, but there is plenty of people who would line up to get in.
嗯……看起来似乎任何具备足够优秀成绩的人都有机会进入医学院。但实际上，只有那些获得顶级高分的候选人才能被录取，而且医学院的辍学率极其低。想成为医生的人并不少。我并不是说医学专业学习轻松，也不是说我们应该让不合格的人来做这件事，但确实有很多人愿意排队争取进入医学院就读的机会。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
This was a difficult post to understand. The arguments seem a bit exaggerated. I don't think holding doctors accountable is a bad thing. Did I read that right, that doctors working 80 hours a week are only making minimum wage? That doesn't sound right.
这篇帖子很难理解。论点似乎有些夸张。我认为对医生问责并不是坏事。我读到的是不是说每周工作80小时的医生只能拿到最低工资？这听起来不太对劲。
LM "in the verge of collapse". This is exactly how you fearmonger. When in reality, being a doctor is one of the most lucrative occupations in Korea.
哈哈，“濒临崩溃”。这就是你制造恐慌的方式。实际上，在韩国，医生是最赚钱的职业之一。
Idk, it feels like they are talking about some other korea.
The doctors I know, live a good life.
I though they will talk about how busy the SNU, Asan, Samsung hospitals are:/
我觉得他们在谈论的是另一个韩国。
我认识的医生都过着很好的生活。
我还以为他们会谈到首尔国立大学医院、阿斯汉医院和三星医院有多繁忙。
The doctors I know are living shit life. But they are mostly all 29, 30 year olds just after getting the license, doing residency training at Yonsei or SNU, or doing military service as military surgeons or public health doctors. But they put up with it because they know it's a training phase and it gets better afterward.
While I do agree residents need better treatment and less hours, the original post sound like a rant from a snobby entitled fresh medical student.
我认识的医生过着艰辛的生活。但他们大多都是刚拿到行医执照的29、30岁左右的年轻人，正在延世大学或首尔国立大学进行住院医师培训，或者作为军医或公共卫生医生在服兵役。他们之所以忍受这一切，是因为知道这是个训练阶段，之后情况会变好。
虽然我同意住院医师需要更好的待遇和减少工作时间，但原帖听起来像是一个自命不凡的新医科学生的抱怨。
Resident can legally work up to 88 hours a week, and most work 80 hours a week and earn a little more than the minimum wage.
-Working long, over-bearing and exhaustive hours...isn't this well known fact? Like long before 수능? Why are you complaining with the decision you made?
"Even unintentional medical negligence can result in criminal penalties and can be arrested by the prosecution."
-Unintentional medical negligence's that would potentially destroy a person's livelihood and/or destroy a family... You think a doctor shouldn't be liable?
"Even with all this, all the media have been treating us as criminals for months as greedy doctors."
-That the media has exposed...what of the ones that weren't?
住院医师每周合法工作时间上限为88小时，大多数每周工作80小时，收入仅比最低工资略高一些。
-长时间、过度劳累的工作……这难道不是早就广为人知的事实吗？早在高考（수능）之前就知道了。为什么你现在要对你的决定抱怨？
-“即使非故意的医疗过失也可能导致刑事处罚，并可能被检方逮捕。”
-可能会摧毁一个人生计乃至整个家庭的非故意医疗过失……你认为医生不应该承担责任吗？
“即便如此，媒体几个月来一直把我们当作贪婪的罪犯对待。”
媒体曝光的是……那些没有被曝光的又如何呢？
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
Not to mention all negligence is unintentional, by definition.
顺便说一句，所有过失按定义来说都是非故意的。
Wouldn't more doctors reduce the hours even since they can hire more now?
增加医生人数难道不是因为可以雇用更多医生而减少他们的工作时间吗？
The healthcare system would be on the verge of collapse due in part to doctors abusing their cartel and losing the trust of the public all while nurses bear the brunt of work.
医疗保健系统濒临崩溃，部分原因是医生滥用其行业垄断地位并失去了公众的信任，而护士则承担了大部分繁重工作。。
If Korea’s healthcare system is on the verge of collapse, I wonder how you would describe the US healthcare system.
如果韩国的医疗保健体系即将崩溃，我想知道你会如何描述美国的医疗保健体系。
Interesting since it’s considered one of the best if not the best in the world. A million people every year travel to Korea for healthcare.
I experienced it indirectly when traveling in Korea with my in-laws. My FIL was injured in a fall. He was taken by ambulance to a local hospital, seen by a doctor, wounds treated, antibiotics given, 22 X-rays taken (he’s 87) and a 7 day supply of medication provided. Total cost $315USD.
The average working Korean pays 3.5% of their wages and their employer matches that for a total of 7% to fund Korea’s single payer system. That’s not cheap but it’s not expensive either for what you are getting.
有趣的是，韩国的医疗保健体系被认为是世界上最好的之一，甚至可能是最佳的。每年有一百万人前往韩国接受医疗服务。
我在与岳父母一起在韩国旅行时间接体验到了这一点。我的岳父跌倒受伤，他被救护车送往当地医院，经过医生诊治，伤口得到处理，给了抗生素，拍了22张X光片（当时他87岁），还提供了7天的药物供应，总费用为315美元。
韩国普通工薪族需支付其工资的3.5%作为医保费用，同时雇主也会匹配这一比例，使得总缴纳比例达到7%，用于支持韩国的单一付款人医疗体系。虽然这不是一个便宜的支出，但对于所获得的服务而言，这个价格既不昂贵且相当合理。
Lived in both countries. Korea is cheap and good for small stuff and preventive care. Dental is amazingly good and cheap even without insurance since lots of stuff aren’t covered anyway. But for the big important stuff, sucks and not cheap. I found out the hard way around 50% of the bill is not covered by insurance. Korea health has the yearly max cap out of pocket too but surprise that 50% uninsured part of bill doesn’t have a cap, basically no yearly limit. My hospital was one of the 5 university hospitals in seoul. If I was under my previous US insurance, I would have hit max at 5k out of pocket for the year. Then learned most of my coworkers were paying 1-200 per month on private insurance on top of work health insurance to cover the gaps. US is better when shit hits the fan. It wasn’t the surprising cost that bothered me which ran 10s of thousands in a very short amount of time. The quality of care sucked. It was nearly impossible trying to see or talk to the doctors. Appointments, no joke, the doc set a 5min timer on his iphone. Then once the expensive procedures are done, they transfer you to a “partner” smaller hospital the next day since they need to wheel in the next $$$. But to be fair, they do send a intern with you in the private out of pocket ambulance so you don’t die during transit to the smaller hospital that might not have all specialist in house. But don’t worry, if you have a problem in the small hospital they can’t handle during recovery, you can call a private ambulance to come back to us. Come to our ER, a random intern doc will make a decision to accept you or not into ER first and you have 24hrs before our ER kicks you out for your doctor to find a bed in his department. Don’t worry he will send a intern to check you out in ER and if we can’t find a bed, sorry, rules are rules, call a private ambulance and find a place to go, ER is only 24hrs. Oh and please make a appointment with your doc for your next visit since we feel kinda bad you stayed in ER 24hrs and had to leave even though you are our patient and told you to come back if issues from the procedures we did. His next availability to see you at his office is 8 days from now. Oh you are unconscious and can’t wait that long or make a appointment. Well, then your family can get signed papers from your current hosp doc that you are physically incapable of coming in for an appointment, make an appointment and they can come to explain your situation in 5 mins that he has for your appointment. No they can’t see him right now, only appointment or come through ER. Oh you did that and was kicked out after 24hrs because out of the 3 different department doctors you with us, non had a bed available. Oh sorry, then you should make a appointment and they can make an assessment if you need to be brought in. Oh of course only your doctor can make a proper assessment from physically seeing you but you are unconscious and he can’t come out to see you at the hospital we sent you out to for the second time and he has no room for you in his department, your non-doc family explaining your vitals to him is the only option. He can make an assessment that way and hopefully find space to bring you back into his department to take care of you…..
I wish I was joking. Lived in both countries. If I had a choice, I would have flown back to the US to get treatment. Sure people fly in for small stuff, preventive care, and cosmetic and I would still recommend it but big stuff and I am not even talking about some rare thing or being mangled completely in a car accident but if shit shit hits the fan, what I wrote is only like 30% of the crap I had to deal with.
我在两个国家都生活过。韩国在小病治疗和预防性保健方面既便宜又不错，牙科更是惊人地好且便宜，即使没有保险也能负担得起，因为很多项目本来就不在保险覆盖范围内。但是面对重大疾病时，韩国的情况就不太理想了，并且费用不菲。我以艰难的方式发现，大约50%的医疗账单是保险不报销的。韩国医保的确有年度自费上限，但令人惊讶的是，那50%未投保部分却没有上限，基本上没有年度限额。我当时所在的医院是韩国首尔五所大学医院之一。如果我当时在美国并且使用之前的医保，一年中个人支付部分达到5000美元就会达到上限。后来我发现，许多同事每月还要额外花100至200美元购买私人保险，以弥补医保缺口。
美国在遇到严重问题时的医疗服务更好。令我不满的并非高昂的费用（短时间内高达数万美元），而是医疗服务质量低下。很难见到或与医生交谈，预约看病简直像开玩笑一样，医生甚至会在iPhone上设置5分钟倒计时。昂贵的治疗结束后，由于要接纳下一位付费患者，他们会在第二天将你转到一家合作的小型医院。不过公平地说，他们会派一名实习生陪同你乘坐自费救护车前往可能不具备所有专科的较小医院，以免你在途中发生危险。但如果在小型医院恢复期间出现问题，你可以呼叫私人救护车回到我们这里。来到我们的急诊室后，一名随机分配的实习医生会先决定是否接收你进入急诊室，而且你只有24小时的时间让主治医生为你找到病房床位。别担心，即使在急诊室等不到床位，主治医生也会派实习生来查看你的状况，如果实在找不到床位，抱歉，规定如此，只能叫私人救护车去找其他地方，因为急诊室只提供24小时服务。记得提前预约下次就诊，因为我们觉得你已经在急诊室待了24小时还不得不离开，这很不好，尽管你是我们的病人并被告知有问题随时回来。主治医生办公室下一次的预约时间是8天后。如果你昏迷无法等待或预约，那么你的家人可以从目前所在医院的医生那里获得证明文件，说明你身体状况无法亲自前来就诊，然后替你预约，并在5分钟的就诊时间内向医生解释你的病情。不，他们不能立刻见到医生，只能通过预约或再次通过急诊室。如果你已经尝试过并因在院内的3个不同科室都没有空余床位而在24小时后被要求离开，那么你应该重新预约，医生会根据情况判断你是否需要入院。当然，只有主治医生亲自检查后才能做出准确评估，但由于你处于昏迷状态，他无法去转诊医院看你，同时他的科室也没有床位给你，因此由非医生家庭成员向他解释你的生命体征成为唯一选择。医生可以通过这种方式进行评估，并希望最终能找到床位让你重新回到他的科室接受治疗……
我希望我在开玩笑，但以上所述都是亲身经历。在两国都生活过的我，如果有选择的话，我会选择飞回美国接受治疗。确实有人飞到韩国来做小手术、预防性保健和美容手术，对此我还是会推荐，但对于大病，我不是指罕见疾病或者遭遇严重车祸，而是在真正危机时刻，我上面写的内容仅仅是我所经历的麻烦中的30%而已。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
This reminds me of German media doomposting during the pandemic that GKV is screwed up as shit which never really happened. I mean... is there any national healthcare from developed nations that people say is sustainable?
这让我想起疫情期间德国媒体关于GKV体系崩溃的悲观报道，当然实际上并没有发生。我是想问，有没有哪个发达国家的国民健康保健制度被认为是可持续的呢？
National health insurance being depleted by a aging population definitely is a problem.
人口老龄化导致国家医疗保险耗尽，这绝对是个问题。
I'm genuinely curious about one comment that was made in the original post here. Do residents earn little more than Minimum wage? Really? Then shouldn't they instead be advocating to increase the wages of residents? and are residents included in the Doctor's unx in Korea? Also how do residents wages in Korea compared to other countries in the OECD for example?
我对原帖中的一个评论感到好奇。住院医师真的只比最低工资多挣一点吗？如果是真的，他们不是更应该倡导提高住院医师的薪资吗？此外，在韩国，住院医师是否包含在医生工会中？韩国住院医师的工资与其他OECD国家相比如何？
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
doctors make "little more than the minimum wage"?
a 5 seconds Google search says: the average resident physician general practice gross salary in Seoul, South Korea is ₩131,075,468.
I don't know how accurate that is, but a "little more than the minimum wage" = +100K than the minimum wage
医生收入“只比最低工资多一点点”？ 谷歌搜索5秒钟显示：韩国首尔普通内科住院医师的平均月薪为₩131,075,468。
我不清楚这个数字有多准确，但“只比最低工资多一点点”的说法意味着比最低工资高出大约10万韩元。
I Think he meaned residents who are training in hospital, not licensed doctors. I am friends with many doctors and they are earning > 100 000 000 won/ year.
我认为他说的是在医院接受培训的住院医师，而不是已取得行医执照的医生。我和很多医生朋友关系很好，他们的年收入超过1亿韩元。
I dont know where you got that number. But it is true that residents get overworked and get paid poorly for the hours. My friends in Severance or SNU usually get about 4,000,000 ₩ ish per month pretax. While the hospitals have to ovey the 88 hour rule, they usually resort to bypassing the electirc medical record to actually work more overtime than reported hours. So 90-something hours / week for 4,000,000 a month do end up a little bit over minimum wage if you divide by the hour. http://www.docdocdoc.co.kr/news/articleView.html?idxno=2018793
我不清楚这个数字是从哪里来的，但住院医师的确过度劳累，并且按工作时间计算薪水很低。我在延世或首尔国立大学的朋友通常每月税前收入大约400万韩元左右。虽然医院必须遵守88小时工作制，但他们通常会绕过电子病历记录，实际上加班时间远超报告的工作时间。因此，每周90多个小时，一个月400万韩元，折算下来每小时略高于最低工资标准。
相关报道参见：http://www.docdocdoc.co.kr/news/articleView.html?idxno=2018793
lM you're fine. more than fine.
take a look at european countries and how long people have to wait to get an mri scan or to see a specialist.
it's months up to half a year.
also, we really, desperately need doctors and nurses.
i'm a psych nurse in public service but even we are understaffed constantly since covid.
the situation at retirement homes and hospitals is even worse.
talk about a real collapsing system...
minimum wage? which kind of minimum wage?
that's a bit too vague and seems like op is purposefully obscuring something here.
a quick google research says they earn almost 60000 won per hour, which is 40 euros or 45 u.s. dollars.
basically whining with a privileged attitude.
the issue isn't that there aren't enough doctors.
the issue is that there aren't enough willing to specialize in certain fields but go for those, that will earn the most profit, such as plastic surgery.
there's generally a lack of pediatricians, dermatologists, otorhinolaryngologists everywhere.
比起其他国家，韩国的情况已经很好了。欧洲国家人们等待MRI扫描或看专科医生往往需要数月至半年时间。现在社会急需医生和护士，尤其是在心理健康领域、养老院和医院，人手严重不足。关于最低工资的说法太模糊，经搜索发现，韩国医生每小时收入接近60,000韩元，相当于40欧元或45美元，所以原帖中的态度更像是享有特权的抱怨。问题不在于医生数量不足，而在于缺乏愿意在儿科、皮肤科、耳鼻喉科等领域专业化的医生，许多人选择了像整形外科这样利润丰厚的领域。
take a look at european countries and how long people have to wait to get an mri scan or to see a specialist.
it's months up to half a year.
Stop with the fearmongering. I lived in France for a very, very long time and never ever waited more than a week to see a specialist. It takes longer to see a specialist in the US.
“在欧洲国家等待MRI或专科医生的时间可能长达数月到半年”
别再危言耸听了，我曾在法国生活很长时间，从未遇到等待超过一周才能看专科医生的情况，相比之下在美国看专科医生等待的时间更长。
The National Health Insurance is already on the verge of depletion due to the aging population.
This crazy to hear considering I kick up almost 90만원/month for NHIS + pension...
由于人口老龄化的压力，国家健康保险基金几乎耗尽，听到这一消息真是令人震惊，考虑到我每月缴纳将近90万韩元（注：₩900,000）的国民健康保险和养老金，这种情况实在让人难以接受。
It's a combination of the aging population, the perpetually declining birth rate, and the previous president massively increasing "free stuff" that's paid out of the NHI fund. At the same time, the NHIS rates haven't kept up with inflation so doctors are being reimbursed below cost. So they spend their time upselling patients on out of pocket stuff so they don't go bankrupt.
That doesn't bode well for the solvency of a system that was designed on an assumption of a growing population.
当前的问题是多方面因素共同作用的结果：一是人口老龄化趋势加剧，二是生育率持续下滑，三是前任政府大幅增加了由国民健康保险基金（NHI）支付的“免费福利”。与此同时，国民健康保险的费率未能跟上通货膨胀的步伐，导致医生的实际报销金额低于诊疗成本。因此，为了维持运营不破产，医生不得不花费更多时间向患者推销自费项目。
这种情况对于一个基于人口增长假设设计的医保体系来说，其偿付能力和长期可持续性都蒙上了阴影。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
I remember visiting South Korea and was marveled that the Korean health care system was so much better compare to USA.
But with aging population and low birth rate I can see this imploding.
I thought about retiring in South korea but now I have to reconsider. Biggest reason is the health care but again low birth rate and aging population does not help.
Biggest issues is Koreans are so into status and keeping up with the jones. Plus with super competitive nature you see in school and passive aggressive behavior in the work place. I can see the low birth rate.
我记得我原来在韩国时曾对韩国医疗保健体系比美国先进很多感到惊讶。然而随着老龄人口的增长和低生育率问题的凸显，我预见到这个体系可能会陷入困境。
原本我还考虑在韩国退休，但现在不得不重新考虑。最大的原因就是医疗保健问题，而低生育率和老龄化加剧了这一担忧。
韩国人非常注重地位，并热衷于与他人攀比，加上在学校中所见的极度竞争性以及职场中的消极对抗行为，我完全能理解为什么生育率会这么低。
You mean the “perks” of being a doctor and feeling superior are coming to an end? LM
你的意思是，作为医生所享受到的额外好处以及那种优越感即将走向终结？哈哈（LM）
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处
Hate to break it to you but physician training is no better in other countries including USA.
It’s basically slave labor.
OP sounds like a burnt out intern / resident crying for help.
很遗憾告诉你，包括美国在内的其他国家，医生的培训情况也好不到哪去。基本上就是苦力劳动。
原发帖者（OP）听起来像是一个已经精疲力尽的实习医生或住院医师，在寻求帮助。
Old people need medical treatment more than any other demographic and there will be more old people in the future due to low birth rates. The pension system is also going to collapse. It looks like national social security is on the verge of being a failed system.
Yet we currently see massive increase in luxury spending and tourism. Yet these are the same people that will probably have to pay for their own retirement in the future.
老年人群体对医疗的需求远超其他年龄段，而由于低生育率的影响，未来老年人口将会更多。与此同时，养老保障系统也将面临崩溃。看来国家社会保障体系正处于失败边缘。
然而，目前我们却看到奢侈品消费和旅游业出现了大规模增长。这部分热衷于奢侈消费和旅游的人群很可能在未来需要自己负担退休生活费用。