On the night of May 1, a woman in her 30s experienced bleeding at an obstetrics clinic in Cheongju, North Chungcheong Province, in an emergency situation where the fetal heart rate dropped sharply. The clinic sought urgent transfer to higher-level hospitals in the region, including Chungbuk National University Hospital, but all hospitals refused to accept her. After 119 emergency responders received the call and contacted 41 hospitals nationwide, a helicopter was dispatched to Dong-A University Hospital in Busan, and the patient was transferred after 3 hours and 20 minutes. Emergency surgery saved the mother's life, but the fetus died. This comes just three months after a February tragedy in Daegu, where a pregnant woman carrying twins and showing signs of premature labor wasted four hours on the road before being transferred to a hospital in the Seoul metropolitan area, only to lose one of the twins.
The "ER merry-go-round" — where patients lose their lives after missing the golden hour while being shuttled between hospitals in ambulances — continues to repeat. Successive governments have rolled out countless measures and poured in budgets, but the ER merry-go-round has not stopped. This delivery-room merry-go-round is particularly painful. The Lee Jae-myung administration designated 20 regional maternal and child medical centers, supported each with 1.6 billion won in budget, and pledged "24-hour delivery and high-risk newborn care." Yet when an emergency struck in the field, the policy did not function at all. Chungbuk National University Hospital, which refused to accept the pregnant woman, was the regional maternal and child medical center serving as the core hub for the Chungcheong region.
The biggest reason Chungbuk National University Hospital could not accept the patient was a shortage of personnel. A regional maternal and child medical center must secure at least four obstetrics specialists, but Chungbuk National University Hospital had only two. Even that was reduced when one went abroad for training, leaving a distorted structure in which a single doctor handled 24-hour continuous care. Other higher-level hospitals in the region that serve as local maternal and child centers also failed to play their role due to chronic staff shortages and a lack of neonatal intensive care unit beds.
As the controversy spread, Prime Minister Kim Min-seok said on social media Sunday that he "feels a heavy sense of responsibility," pledging to "create a 'Korean-style maternal and child specialty hospital' model that enables regional healthcare to thrive together without personnel concentration." Health and Welfare Minister Jeong Eun-kyeong also held an emergency meeting with the medical community and announced measures to operate a real-time patient transfer information system starting in June, while from July expanding the scope of state compensation for unavoidable medical accidents to include severe disabilities of mothers. Though belated, it is fortunate that the government has at last recognized the gravity of the situation and begun to address it.
But there is an essential point that must not be forgotten in this incident. The ER merry-go-round is not merely a problem of the transfer system but the inevitable result of the collapse of the regional and essential medical care ecosystem. Essential medical fields including obstetrics carry brutal workloads, absurdly low medical fees, and the burden of criminal punishment in the event of medical accidents. In a distorted structure where doctors bear all the risk, specialists have left emergency rooms and new applicants have dried up. In contrast, the phenomenon of doctors flocking to the so-called "DOPS" fields — dermatology, ophthalmology, plastic surgery, and orthopedics — which offer higher incomes and relatively better work-life balance, has not changed. Leaving this reality unaddressed while simply sharing emergency patient transfer information and hanging up maternal and child medical center signs cannot possibly make the system work properly.
The government plans to recruit several hundred additional doctors annually through a "regional doctor program" starting in the 2027 academic year, requiring them to serve mandatorily for 10 years to expand regional and essential medical personnel. But at least 15 years are needed before they can be deployed to the field, including specialist training. Above all, unless the structural problems of judicial risk for medical accidents and the distorted medical fee compensation system are resolved, it will be difficult to keep them in delivery rooms and intensive care units after their mandatory service ends.
The ER merry-go-round is not a simple medical accident but the result of a flawed national system. Patchwork prescriptions such as improving the transfer system or offering slightly higher allowances cannot save the essential medical care ecosystem standing on the edge of a cliff. Essential medical care, which is directly tied to life, is core infrastructure that the state must defend even at enormous cost. The state's responsibility for unavoidable medical accidents must be drastically strengthened immediately to reduce the burden of criminal punishment on essential medical staff, and high-difficulty medical practices that save lives must be supported with a bold compensation system. Protecting the lives and safety of the people is the most basic and urgent duty of the state. The question that President Lee Jae-myung posed in 2024 as opposition leader — "The ER merry-go-round: what is the government for?" — remains valid today.
