Public Health Master Plan Press Briefing Session
Date: July 23, 2012
Venue: Seoul Medical Center
What is your body temperature now? It is probably 36.5 degrees, the temperature of a healthy person. Unfortunately, an increasing number of people are finding it difficult to maintain this temperature. Healthy citizens have the right to receive healthcare services, and citizens suffering from illness have the right to proper care as well. But so far, these two rights have not been properly addressed in the public health sector.
When ill, most people prefer private to public healthcare. Public healthcare used to provide only the most basic care to the most vulnerable citizens, such as those in the low income brackets. However, the “Seoul City Public Health Master Plan” we are announcing today will expand public healthcare to all citizens.
We have reinforced preventive health policies in order to ensure that all citizens’ right to good health is respected. And for citizens who are ill, we will provide proper medical services. Allow me to elaborate in greater detail.
In order to treat an illness, a doctor must know the cause of the disease. This applies to the city of Seoul as well. In order to devise a proper public healthcare policy, we need to examine the current health status of our citizens. With advancements in medical technology and the establishment of the health insurance system, the mortality rate of our citizens is declining, and their average life expectancy is increasing. But upon closer inspection, you will see there is a stark contrast in the mortality rates among different districts. This red section here indicates the highest mortality rate. Jungnang-gu showed the highest mortality rate with 469 deaths for every 100,000 people. In contrast, this grey section here, Seocho-gu, had the lowest mortality rate with 335 deaths out of 100,000. This naturally leads to the concern that the income gap is also resulting in a health gap.
It is always better to prevent an illness rather than treat it after the fact. The most serious adult health condition in Korea is high blood pressure, and the number of people suffering from high blood pressure has almost doubled over the past decade as our diet has become increasingly westernized. But, in fact, this is a lifestyle disease that can be controlled by taking preventive measures in our daily lives. Related preventive health services are almost non-existent in the private sector, which is mainly focused on generating profits; therefore, this is where public healthcare institutions must step in to fill the gap. But even in Seoul, with a population of 10 million, public healthcare infrastructure is desperately lacking. The proportion of public healthcare institutions to private clinics in Seoul in 2010 was a mere 0.66 percent, much lower than the nationwide average of 12.6 percent. With such a lack of public healthcare institutions, we cannot provide sufficient preventive medical services to our citizens.
In such a situation, how can we ensure the health of the citizens of Seoul? Some 1,000 people, including healthcare experts, civic healthcare associations, and citizens, held 118 sessions of discussions and meetings, and we have gathered their opinions. We have continuously worked and coordinated with public servants in government ministries, within the Seoul Metropolitan Government, and in other organizations in order to cooperate with the central government. As a result, we managed to establish the basic direction for the Seoul Metropolitan Government’s healthcare policy, called “Healthy Seoul 36.5”.
The Seoul Metropolitan Government will adopt the following measures in order to realize the goals of “Healthy Seoul 36.5”.
First, we will increase life expectancy by helping all citizens, young and old, take care of their own health.
Second, we will narrow the health gap between classes and regions. Specifically, we will reduce the difference in the district mortality rates to less than 10 percent by adopting and implementing thorough healthcare policies that support the health of the citizens all year round.
We will first provide the Citizens’ Healthcare Service to strengthen disease prevention and healthcare. By providing a medical service tailored to Seoul and a citizen outreach program, we will improve the city’s hospitals and enhance the quality of the public healthcare system. We will also ensure all citizens’ right to good health by enabling them to become not only the beneficiaries of healthcare policy, but to also participate in making proposals and decisions and implementation.
Let me explain to you exactly how we will achieve this.
In order to make our citizens healthier and narrow the health gap, we will adopt the following six policies.
Mothers with babies and young children who find it difficult to go out and move around will no longer have to go to a medical facility for healthcare services; the Seoul Metropolitan Government will go to them. Additionally, we will support indoor no-smoking policies and non-smoking environments in order to reduce smoking, the greatest threat to the people’s health.
Everyone probably knows that the best way to achieve good health is exercise, but as we all know, it is not easy. So, we will combine health initiatives with sports that people can enjoy on a daily basis in a bid to increase the number of people engaging in physical activities at their neighborhood sports facilities. It is very unfortunate that Korea has the highest suicide rate, especially among the elderly and youth, among OECD countries. It is five times higher than that of New York City. The Korean word for suicide is “jasal,” but when read backwards it is “salja,” which translates as “Let’s live”. If we strive to live together and prevent suicide, we can persevere. In this regard, Nowon-gu is already acting as a model district. The Seoul Metropolitan Government will join in this valuable cause by pursuing suicide prevention projects customized to each region, striving to make Seoul a city of compassion.
We will construct a health management system to fill any blind spots in the healthcare system, and develop the Seoul Environmental Health Policy, which will cover the management of harmful and cancer-causing substances. We will also carry out preventive management projects for vulnerable classes and regions.
In particular, the home healthcare service for infants and mothers is one of the services through which the Seoul Metropolitan Government tends to the long-term health of its citizens. Our lifetime health management efforts begin not from the cradle but early in the pregnancy, even before the baby is born. We will focus our efforts on promoting the health of infants before they reach the age of five, the period in human physical development that has the greatest influence on our lifetime health, thereby creating a virtuous cycle of good health. Also, a child’s health is directly influenced by the mother’s health. Therefore, within the first 20 weeks of conception, and after childbirth, the Seoul Metropolitan Government’s nurses will visit pre- and post-partum mothers in their homes to offer professional health management services for them and their infant children. Starting next year, we will operate this program as a pilot project.
The greatest cause of death among Korean men is lung cancer. I assume you are all well aware of how detrimental smoking is to our health, but the effects of second-hand smoke are also quite serious. Recognizing this health risk, the Seoul Metropolitan Government will strive to protect its citizens from the risks of second-hand smoke. Next year, we will adopt a wide-ranging no-smoking policy for all buildings in order to minimize public exposure to second-hand smoke. For smokers, we will operate a customized no-smoking clinic that will make house-calls to smokers who are struggling to kick the habit. In addition, we will lead the effort to expand non-smoking environments through media campaigns and regulations on tobacco advertisements.
The second major task that needs to be completed to achieve “Healthy Seoul 36.5” is to enhance the quality of Seoul’s medical services.
We all need doctors, both in sickness and in health. In consideration of this need, we plan to install a citizen health management system through the health professional service at our community health centers, and to ensure these health centers are easily accessible to all citizens, we will establish more Seoul-type community health center branch offices. For those who still have trouble accessing them, we will provide professional health consulting services through the Seoul Healthy Call Center Service. In this way, we hope to better manage the major lifestyle diseases—high blood pressure and diabetes. We have also adopted a system where patients receiving treatment for, and education on, high blood pressure and diabetes accumulate citizen health points, which can be used to reduce the burden of health checkups and vaccinations.
Nursing a family member is always difficult. So, to make it a little easier, the Seoul Metropolitan Government plans to operate a hospital where caregivers provide the support and assistance normally provided by the patients’ guardians. We will also develop professional, customized emergency medical services for the elderly, children, women, and citizens suffering from mental illnesses.
I think that of all these measures, the policy citizens will find most effective is the health professional service at our community health centers. After receiving your medical checkup results, some of you may have been at a loss as to how you should manage your health, but if you take your results to a community health center, the doctor there will help you set up a health management plan tailored to your specific needs. At our health centers, which will be accessible to all citizens of Seoul, you will be provided with services related to quitting smoking, moderating drinking, and exercise and nutrition.
There are many private clinics that focus on treating illnesses, but there is a serious lack of healthcare institutions specialized in health management and disease prevention. So, we are planning to create 75 Seoul-type community healthcare center branch offices tasked with looking after the health of local residents. There will be two types of these branch offices: a standard community healthcare center, offering disease prevention and health management and rehabilitation services, and a participatory community healthcare center, which supports the self-management of residents’ lifetime health.
If a family member falls ill, it affects the lives of all other family members. It is painful for the family, and the hospital expenses are a great burden, not to mention the difficulties involved in long-term care. But these days, as families are growing smaller and more women are participating in the economy, it is not easy for a family to care for a sick family member. Moreover, nursing services are not covered by health insurance, resulting in a significant financial burden. Therefore, we will operate a “no guardian hospital” by increasing the number of nurses and providing high quality services. Beginning in 2012 with the Seoul Medical Center, we will expand this program to all city hospitals.
These policies were not established single-handedly by the Seoul Metropolitan Government. They involved considerable participation by citizens.
Above all, we need the participation and assistance of medical professionals. As such, we will increase opportunities for re-employment and volunteer services for unemployed or retired medical professionals living in Seoul, allowing them to participate in the public healthcare initiative of the Seoul Metropolitan Government.
We will also vitalize and support regional health associations that play a role in public healthcare, and promote and provide support for the voluntary activities of some 150 private medical volunteer groups currently operating in Seoul. We also plan to operate an ombudsman for patients’ rights and host a Citizen Health Meeting, which should enable citizens to participate in the establishment of their own healthcare policy. Additionally, we will offer integrated treatment services to people whose rights have been denied.
Now, I would like to introduce to you the “Ombudsman for Patients’ Rights” as a detailed example of our policy. We will operate this ombudsman in an effort to protect the rights of patients and provide any necessary relief, as citizens are often at a disadvantage when it comes to medical care due to the highly specialized nature of the field. We will operate a medical complaints advisory group, comprised of lawyers, doctors, and consumer associations, to deal with complaints regarding medical services by providing counsel on medical-related problems and infringement of rights. I am sure there are a multitude of questions citizens will ask, such as questions regarding what disease they have, how it can be cured, and the existence of alternative treatments. Nevertheless, many people find it difficult to ask their doctors, so we will strive to enhance and protect the patients’ right to know.
The most fundamental factor influencing our health is lifestyle, as poor lifestyle habits have been shown to lead to serious illnesses. Living conditions are another factor.
We intend to support and vitalize regional health associations, allowing residents to take part in creating healthy communities. We also plan to carry out our public role by building a network of cooperation with community health centers (and branch offices). We hope to provide personnel and material support to health cooperatives and regional health associations acting as regional health and welfare communities.
Modern people suffer not only from illnesses of the body, but also of the mind. One particular example is long-term psychological trauma suffered during an accident. The body heals, but the mind remains damaged. To address such mental health issues, we will provide comprehensive treatment that includes the treatment of physical, psychological, and social welfare problems. Such treatment will be provided to those who suffered in the Yongsan tragedy, the victims of the mudslide in Umyeonsan Mountain, the laid-off Ssangyong Motors employees, and people who have suffered social traumas, such as the torture inflicted on some citizens by previous governments—a deep wound in Korea’s modern history.
How will Seoul’s public healthcare policy, “Healthy Seoul 36.5,” change the lives of our citizens?
Before its first cry, a baby born in Seoul will have already received the benefits of Seoul’s public healthcare services. A nurse will visit the mother and baby at their home after the birth, and vaccinations will be provided by the community health center. When that baby grows to become an elementary school student, full of joy and mischief, his or her parents will become very concerned about how much they must teach their child—from proper diet, which directly affects long-term health, to proper teeth brushing. Seoul’s public healthcare service plays a hand in this area as well. Good dental health is said to be one of the five greatest riches in life, and Seoul’s public health dentists will be there to provide support. This service is also available to middle-aged citizens who are busy working. The local community health centers will offer a comprehensive range of health services, from medical checkups to health management, and help citizens to learn to take care of their health on their own. They will even provide counselling on nutrition and exercise to support citizen’s preventive health efforts. As people get older, they usually gain a greater appreciation of the importance of health—an appreciation that we share. We will offer healthcare services for all senior citizens by transforming a former center for dementia patients to a health enhancement center for senior citizens. We will also increase the number of visiting nurses and provide mobile medical services to the elderly with mobility issues.
“Healthy Seoul 36.5” will take care of Seoul’s citizens throughout their entire lives, from their mother’s womb to the grave, and will be there for our citizens every step of the way along their journey through life.
In order to ensure the effectiveness of this policy, we will conduct a health equity impact assessment on all of the administration’s policies and operate a project evaluation system. In addition, we are going to establish measures that will allow us to acquire the manpower required for policy sustainability and install and operate the Seoul Health Committee.
The most important factor in the implementation of any policy is its budget. Compared to other cities around the world, Seoul’s budget is considerably small for a city this size. In 2011, the proportion of Tokyo’s budget dedicated to healthcare was 7.5 percent, while the same proportion was 4.7 percent in Singapore and 2.3 percent in New York. Meanwhile, Seoul’s budget for healthcare was only 1.3 percent. Recognizing this disparity, we plan to gradually increase the city’s healthcare budget from 1.3 percent in 2012 to 1.8 percent in 2013, and increase it further to 2.3 percent in 2014.
Today, I announced “Healthy Seoul 36.5,” Seoul’s master plan for public healthcare. Through it, we will strive to promote the health of our citizens, throughout all stages of life, and eliminate the inequalities in our healthcare system. The Seoul Metropolitan Government will protect all citizens’ right to health.
We will also protect their rights when they are ill, by providing our best healthcare services and all necessary treatments and ensuring their rights as patients.
Today marks a starting point for positive change in the lives of all citizens of Seoul. Thank you.