The effectiveness of government response to the COVID pandemic is often judged based on a few statistics. These statistics also shape perceptions of each country’s public health system. It is easy to assume that the lower the COVID cases and mortality rate, the more capable the government, and the stronger the public healthcare system of the country. In fact, this conclusion is true to a limited extent. The figures often fail to reflect the loopholes in public health that have manifested in similar patterns globally. 

South Korea has been recognized for its rapid control of transmissions with comprehensive testing methods, contact tracing, and the provision of clear guidelines for quarantine. However, the seemingly impressive capability to manage the outbreak conceals the precarious aspects of its healthcare system that exacerbate health inequities. On October 20, the Korean government officially apologized for the death of a high school student, Jung Yu Yeop, who was rejected from hospitalization despite his fatal condition because he was classified as a potential COVID patient. This was the first time the government recognized the problem after Jung’s death in March 2020. At the time, COVID cases had surged in Daegu and Gyeongbuk regions, and mandatory PCR testing was a part of the manual at every hospital, including in cases of emergency. Jung’s father spoke at the state audit of the Korean Health and Welfare Committee, criticizing the government’s disregard of non-COVID patients in the name of proper quarantine, and called for an increase in public hospitals that can accommodate all patients for timely and effective treatment.

The shortage of public hospitals in Korea is a fundamental flaw in its healthcare system. The proportion of public hospitals constitute merely 5.8%, which is about one-tenth of that of average OECD countries. Due to the marketization of healthcare services, quality healthcare is provided in private hospitals, mostly located in the capital city. According to Dailymedi, there are 260 doctors per 100,000 people in Seoul, but that number decreases to about 100 in regions distant from the capital, indicating a significant regional gap in healthcare services. These factors are held accountable for the events that were not highlighted in the media: public hospitals taking 78% of all COVID patients in Daegu city, half of the patients requiring intensive care being refused from admission and treatment, and 70% of the patients who passed away not having received ventilator support. 

Indeed, the issue of privatization is prominent in other countries as well. Private hospitals in Low and Middle-Income Countries (LMICs) including India, Costa Rica, Mexico, Turkey, Malaysia, and Ecuador have accredited facilities that cater to wealthy international patients. Medical tourism emerged as a globally competitive market worth 38 billion USD, according to the Business Research Company. When COVID-19 caused disruptions in insurance payments to private providers, this financial burden was coped with through accepting patients based on their ability to pay for healthcare services. Besides LMICs, nations such as the US and the UK have also confronted similar trends. According to the Guardian, private hospitals in the UK allocated merely 0.08 % of total beds to COVID patients. 

Governments have taken different approaches to overcome the limitations of private providers. For instance, Thailand introduced a law banning private providers from charging COVID patients, while Indonesia, the Philippines, and Malaysia implemented fixed pricing of COVID-19 treatment. Other legislation included financial bailouts to private providers or attempts to nationalize private hospitals. However, these policies were not without their flaws. In South Africa and Peru where private healthcare is dominated by a few firms, the market power allowed huge amounts of financial aid to be allocated to such firms. This market power could also be utilized to threaten the government to close down health facilities without additional subsidies or lifts of fixed pricing of COVID patients. Thus, the for-profit nature of private providers has and will continue to hinder effective and equitable responses to health emergencies.

The current healthcare system fails to guarantee equal access to quality healthcare. Many important problems, such as the understaffing of healthcare workers and the focus on treatment rather than prevention and health promotion, still remain unsolved. Despite the enumerated challenges, however, the urgent need to reform and strengthen the public health sector and improve health inequity in preparation for future public health emergencies can’t be stressed enough.