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Freedom Factory Newsletter #5

프리덤인턴 | 2014.05.14 18:55 | 조회: 461 | 덧글보기(0)
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"What light is to the eyes - 
what air is to the lungs - 
what love is to the heart, 
liberty is to the soul of man."

-Robert Green Ingersoll

May 14, 2014

* episode 3 of the Casey Lartigue Show has been released!: "Medical care in North Korea: Bring your own beer bottles." (click for link)http://www.youtube.com/watch?v=TBTkVZVnd7M 

Is it possible to do wrong even when you are right? That’s the situation Korean doctors are in now. They have been threatening to launch full-scale strikes, as they did during 1999-2000. 

They are certainly entitled to go on strike, as they battle with the government over policy. However, they are putting patients in danger by going on strike.

Doctors do make some solid points. One, the amount that they are legally allowed to charge does not cover the cost of providing treatment. Two, many lose money because of government price controls. To avoid losing money, doctors must often work overtime and treat more patients in order to avoid losing money. It is indeed a system that is problematic.

However, their patients are also suffering from the government’s price controls. As doctors fall into the tempting cycle of over-treating patients, patients in turn are being jeopardized by unnecessary diagnoses and risky operations. What is an even more serious problem is that the department of internal medicine, surgical department, gynecology wards, and other such departments that often deal with life-or-death situations are being discarded for other, less critical practices of medicine. 

While some are dying of heart disease or in critical condition while giving birth, doctors are increasingly choosing to work in cosmetic surgery or dermatology, creating dire need for more real doctors to save lives. In order to fix this, we need the universal health care providers to step up and take lead. If you want medical welfare then you must collect the necessary funds through taxation. If you will not tax, you must give up on this social welfare. Squeezing such funds from the doctors is unethical. It is not sustainable.

In spite of these circumstances, the method must be a legitimate and legal one. If we continue in the current way, those being affected and suffering will resort to collectivized action and fill the streets with protests.
The Republic of Korea is a constitutional state. Though there may be injustice or dissatisfaction with the current way of things, we must use proper procedure to fix this problem. I urge you to recall the video equipment fee litigation incident in which the doctors emerged victorious.

Likewise, you should petition for a change (constitutionally) in this wrongful system of unjust intervention by public officials into the medical sector. If not for this method, there are many other methods you can harness. Perhaps you are regressing back to using primitive methods after having lost (just once) at a trial regarding universal health insurance.

Further, I understand that it is difficult and a tedious, long process but in any case you must ultimately convince people. Lobbying against public officials and National Assembly members would do no good. Those Assembly members and public officials that most citizens do not embrace will probably not do a thing about it. The counterproductive intervention by the government and its ills in hospitals must be explained in a manner so that even country-side grandmothers can understand and be convinced.

So even though doctors make many great points, I cannot understand the opposing stance against tele-medical consultation and for-profit hospitals that appear to be the pretext these days. Public officials are attempting to do the doctors a favor by broadening the scope of medical treatments they can partake in for their benefit and yet the doctors are pleading for a continuation of the old system. Why, you ask? Think about the medical consultation issue for example. Currently, no doctor can give tele-medical consultation.

The act is being withheld as some believe it can lead to medical accidents. However, doctors would only give consultation they are confident about as they would become liable otherwise. Refusing these doctors the freedom to use their abilities and knowledge is like clinging to their hind legs to prevent them from moving. Opposing tele-medical consultation in fear that local hospitals would lose patients is none other than an act to make sure opponents of the cause will be able to keep (just) their own food on their tables.

The issue of private hospitals is no different. Isn’t it the case that all doctors are engaging in profit-making? Receiving payment is an act of making profit. Doctors who are resorting to overtreatment are committing worse acts of profit-making. If you think about it, those who are opposing profit-making hospitals are not actually criticizing the profit-making itself, but the open-investment hospitals. 

I can see the underlying reason for why there are such opponents, despite the fact that these hospitals would provide many new opportunities for doctors. They oppose fearfully because competition arising from these open-investment hospitals would reduce medical fees (in turn maybe lower treatment quality). Why are they stemming the innovation of other doctors?

If private hospitals are assented, there is a rumor that the appendix surgery will increase by 10 million won. If this is true, it would provide a golden opportunity for those “virtuous” doctors opposing private hospitals. No patient would ever go to a private hospital that charges 10 million won for an appendix surgery. Doctors who want to charge less could prove they aren’t greedy by charging less.

Doctors opposing private hospitals are maddened about the freedom that is being given to them even though those who do not want to participate in those hospitals can merely stay out of such matters. I cannot understand doctors who are stubbornly protesting to keep a system that is already socialized. 

The dilemma of our nation’s medical situation lies in the reality that universal health care is being striven for at the expense and sacrifice of the doctors and that public officials are intervening in every move of medical practitioners in their medical treatments. I urge you to tackle this situation and face it headstrong. I urge a protest against public officials and their hands on the medical treatment ongoing in our society. And you must persuade the nation. It will be difficult but that is the right method.

Even if you do succeed through this protest, there is not much to gain. Tele-consulting will continue to be banned. And while Korean patients will go abroad to Shanghai and Bankok to get their heart surgeries, Korean doctors will be at their wits end, having to enter the cosmetic surgery departments or dermatology. The subjugation of doctors at the hands of public officials will continue. Is that what you want?

What’s a better way? Freedom. Inform citizens about the harmful meddling of public oficials in medical affairs. Stop overtreating patients. Persuade, not strike. That is the right method of protest. This is a problem you can never hope to solve -even if you take to the streets, holding patients hostage- if you oppose tele-consultation and private hospitals.

(Click for more)

During my mini-speaking tour last month in the U.S., giving speeches in Washington, D.C., Chicago and New York City, I enforced the same rule that I use in South Korea whenever I discuss North Korea: Only one question about reunification will be allowed during Q&A.

The reason for the rule: I have seen many discussion sessions destroyed with most of Q&A focusing on an issue that no one in the audience can do anything about. Reunification is the ultimate talking topic with no direct consequences for being wrong; kind of like debating about your favorite sports team. The reality is that 99 percent of us have no influence on reunification and will never receive invitations to the six-party talks about North Korea’s nuclear weapons.

I try to get audience members to focus on doing something practical. Many people get stumped by that challenge, and continue to ask other intellectual questions that are all talk, no action.

I try to be polite to such questioners, but I do want them to recognize that there is a difference between talk and action, and that their questions and observations should not be mistaken for action. Some will ask, “Okay, then how can we help North Koreans?” But that depends on who you are and what you can do, so I advise people to ask how can “I,” not “we,” help.

The first step to prepare yourself to help is to avoid being distracted, whether real or imagined, by titillating stories about North Korea or fat jokes about the dictator. I suggest two questions to guide people: 1) How does this article inform me in a constructive way about North Korea? 2) How does this story lead to action increasing freedom for North Koreans? With that test, it is clear that most stories are just chit-chat that won’t make a difference.

But how to make a difference? Few engage North Korea directly because of its blockades against information, migration and trade. Most work is done at the edges, such as sending USB drives and other information into North Korea, shortwave radio broadcasts into the country and rescuing North Koreans refugees from China.

There is not one right way to help, as was demonstrated by a fascinating article by NK News asking North Korean refugees how the international community can help. The refugees disagreed among themselves, recommending things from, as the sub-headline suggests, a “mixture of isolation, engagement, and carrot and stick strategies.” So what can individuals do to help, if even North Korean refugees can’t agree?

In my case, I have concluded that my most valuable role is to help North Korean refugees who have already escaped. It is less glorious than attending important international meetings, trips directly into North Korea or holding endless discussions about reunification, I know. As I like to tell people who ask why I am not rescuing people or helping the United Nations do whatever it does, I consider myself to be part of the welcoming party for North Korean refugees who make it to South Korea.

I’m especially proud of the program I co-founded that matches North Korean refugees with volunteer English teachers. I am also proud of my work with North Korean refugee children and adolescents at the Mulmangcho School. I look forward to every time Yeon Mi Park, a North Korean refugee who speaks great English, co-hosts with me the“Casey and Yeonmi Show” TV podcast that we recently launched.

Others may not be interested in what I am doing, and that’s fine. There are many NGOs in South Korea that are helping North Korean refugees. People who want to help can do so by a) volunteering consistently, b) donating money, or c) organizing a fundraiser. Or, they can start their own projects, such as internships and scholarships for North Korean refugee students and professionals.

Those things can help groom future leaders in North Korea, help them develop practical skills and help North Korean refugees with their adjustment to the outside world. This can have the side effect of helping them have positive messages about their experiences abroad and to have money to send back to relatives who are trying to escape ― testimonials and help that will be more powerful than even USB drives, shortwave radio broadcasts and others forms of information seeping into North Korea.

Even after I said these kinds of things in the U.S., I was disappointed at a few sessions where the first questions were about landmines, reunification or some titillating story the questioner had heard about North Korea. I am still trying to be respectful about such questions, but I am thinking about a new rule for Q&A sessions: No questions about landmines, reunification or six-party talks until after the Q&A session has ended. 

The writer is the director for international relations at Freedom Factory Co. in Seoul and the Asia Outreach Fellow with the Atlas Network in Washington, D.C. He can be reached at cjl@post.harvard.edu.

(Click for more)

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