Controversy Over 100% Out-of-Pocket Costs for Mild Conditions if Jeju Hospital Is Designated a Tertiary General Hospital

Jeju Governor: "Costs Are Somewhat High"
Out-of-Pocket Costs for Follow-Up Visits Rise 1.6-Fold
Jeju National University Hospital Has Just One Obstetrician

As designation as a tertiary general hospital would require patients to pay the full cost of outpatient follow-up visits for 105 mild conditions, including hypertension and diabetes, Jeju Special Self-Governing Province Governor Wi Seong-gon called the cost burden "somewhat high" during a provincial policy question session and described the province's medical system as "optimized." Critics say his assessment is out of touch with the reality of gaps in local childbirth and emergency care: Jeju National University Hospital, the regional maternal and child medical center, has only one obstetrician on staff.

Kang Chung-ryong of the People Power Party questions Jeju Governor Wi Seong-gon about the burden of medical expenses for patients with mild conditions and plans for alternative hospitals following the designation of a tertiary hospital during the plenary session of the 456th second regular session of the Jeju Provincial Council on the 11th. Governor Wi sparked controversy when he described as “somewhat high” the policy requiring patients to pay 100% of medical expenses for follow-up visits for mild conditions. Provided by the Jeju Special Self-Governing Provincial Council.

During a provincial policy question session at the plenary meeting of the Jeju Provincial Council's 456th second regular session on November 11, Assemblyman Kang Chung-ryong of the People Power Party asked whether Jeju National University Hospital would continue treating existing patients with mild conditions if it were designated a tertiary general hospital.

Governor Wi replied, "Patients with mild conditions can still receive treatment, but the medical costs are somewhat higher than at general hospitals."

However, under criteria set by the Ministry of Health and Welfare, patients receiving outpatient follow-up care at a tertiary general hospital for any of 105 mild conditions, including diabetes, hypertension and rhinitis, must pay 100% of the total medical bill, rather than receiving the additional reimbursement rate for medical care.

At Jeju National University Hospital, currently a secondary hospital, patients pay 62.5 out of 125, which includes a 25% surcharge on a base medical fee of 100. After the hospital is designated a tertiary hospital, they would have to pay the full 100, increasing their out-of-pocket costs by 1.6 times.

The patient copayment rate at pharmacies would also rise from 40% to 50%, and patients would no longer be covered by the out-of-pocket maximum system.

In response to calls to expand the number of secondary hospitals to accommodate patients with mild conditions who could be turned away, Governor Wi said, "If new secondary hospitals open, hospitals in the province will face worsening financial conditions," adding, "The current hospital system is the most optimized."

He also said that "the current doctors will remain in place" after the hospital's designation, prompting concerns that patients' financial burden could increase without additional medical staff or estimates of the resulting costs for residents.

Contrary to Governor Wi's assessment that the system is "optimized," essential and emergency medical services in the province are facing shortages of staff and infrastructure.

According to materials released by Jeju Province on November 12 on expanding maternity care, an obstetrics and gynecology clinic that handled 25.6% (237) of all births in the province in the first quarter of this year closed in September 2026. The number of helicopter transfers out of the province involving high-risk pregnant women and newborns totaled 61 over the past three years and more, including 12 in 2023, 10 in 2024, 22 in 2025 and 17 as of August 2026.

A view of Jeju National University Hospital (right) and Jeju Halla Hospital, both of which applied for designation as sixth-term tertiary general hospitals. Photo by Park Changwon.

The province plans to invest KRW 9.5 billion from next year's special account for essential local medical services to expand maternity care. However, Jeju National University Hospital, which is pursuing designation as a tertiary general hospital, has only adjusted its eligibility threshold for childbirth care from pregnancies of at least 30 weeks to those of at least 28 weeks.

When our newspaper checked with Jeju Province's health authorities, it found that two of the three obstetricians at Jeju National University Hospital, currently designated as a regional maternal and child medical center, are on leave. This leaves only one obstetrician to care for high-risk pregnant women.

Three gynecologists are on call, but in emergencies involving high-risk pregnant women, the sole obstetrician must be on call around the clock.

In addition, a shortage of pediatric subspecialists makes it difficult to care locally for extremely premature infants born before 28 weeks of gestation (typically weighing less than 1 kg), making helicopter transfers out of the province unavoidable. Jeju National University Hospital plans to increase its number of obstetricians to four by 2027. It was also confirmed that the hospital will continue receiving national operating funds for the regional maternal and child medical center even if it does not recruit additional staff, as long as it meets the requirement of having positions "under recruitment."

Meanwhile, the province's budget for personnel costs next year can only be spent once staff have actually been hired. This has prompted concerns that the funds could go unused unless conditions are put in place to attract medical professionals from the Seoul metropolitan area.

Meanwhile, Jeju Halla Hospital, a private medical institution, recently recruited two obstetrics and gynecology professors from Sinchon Severance Hospital and established a "24-hour emergency childbirth system for high-risk pregnant women" staffed in two shifts. The system began operating this month.

One more specialist is set to join in January 2027, bringing the hospital's obstetrician team to three. The hospital is operating a response system that can provide care for high-risk pregnant women and newborns in the province, in coordination with its 24-hour neonatal intensive care unit (NICU).

A local medical professional said, "We need to consider whether designating a tertiary hospital will actually benefit Jeju residents when even the flagship national university hospital is operating with just one obstetrician and the number of doctors will remain unchanged, while patients with mild conditions will have to pay 100% of their medical costs. As in the case of establishing a 24-hour emergency childbirth system by recruiting specialists, securing an emergency medical safety net tailored to the conditions of an island region should be the priority."

This content was produced with the assistance of AI translation services.