WEBVTT - South Korea Has Plenty of Botox But Not Enough Doctors 0:00:02.720 --> 0:00:11.640 Bloomberg Audio Studios, Podcasts, radio news. Good morning, it's the 0:00:11.680 --> 0:00:14.080 big day. I'm heading out to Korea today. 0:00:14.640 --> 0:00:17.720 That's Julie Miller, a forty six year old stay at 0:00:17.760 --> 0:00:20.639 home mum from New Jersey. She's on her way to 0:00:20.720 --> 0:00:22.919 the airport to fly to South Korea. 0:00:24.120 --> 0:00:28.200 As I'm sitting here, I am noticing all my neck issues, 0:00:28.440 --> 0:00:31.200 so I'm very, very excited for these treatments. 0:00:31.600 --> 0:00:35.920 Those treatments, botox shots and skin tightening are the reason 0:00:36.040 --> 0:00:39.120 Julie's flying to Soul. It's a trip that will take 0:00:39.120 --> 0:00:41.920 her about a day, and the final bill for those 0:00:41.960 --> 0:00:46.199 treatments isn't cheap, about three thousand dollars, but it's almost 0:00:46.360 --> 0:00:50.000 half the cost of doing it back home, and Julie 0:00:50.000 --> 0:00:53.440 says they're worth the distance and every penny. 0:00:54.200 --> 0:00:59.040 The biggest draw was people were very satisfied with their results, 0:00:59.120 --> 0:01:02.320 and that combined with a better price than we have 0:01:02.360 --> 0:01:04.720 in the US, it's like a no brainer. 0:01:05.560 --> 0:01:09.040 Julie is among hundreds of thousands of tourists who travel 0:01:09.160 --> 0:01:12.280 from all over the world to South Korea every year 0:01:12.319 --> 0:01:16.160 for beauty treatments. Bloomberg senior reporter and Big Take Asia 0:01:16.200 --> 0:01:18.720 host One h has been reporting on the rise of 0:01:18.760 --> 0:01:20.319 medical tourism in the country. 0:01:20.720 --> 0:01:24.360 South Korea's medical tourism business hit a record high of 0:01:24.400 --> 0:01:27.399 six hundred thousand people in twenty twenty three, and they're 0:01:27.400 --> 0:01:30.399 on track to get even higher. A third of the 0:01:30.440 --> 0:01:33.679 tourists came in for cosmetic procedures in twenty twenty three, 0:01:33.920 --> 0:01:36.920 and another twenty percent came into Korea for plastic surgery 0:01:37.280 --> 0:01:41.440 right now, plasty facelifts, all that fun stuff. 0:01:42.520 --> 0:01:45.800 It's a growing industry for South Korea's economy, and the 0:01:45.800 --> 0:01:48.760 government wants to turn the country into a medical tourism 0:01:48.880 --> 0:01:52.920 herber in Asia. But as the beauty market thrives, the 0:01:52.960 --> 0:01:55.919 country's medical system faces other challenges. 0:01:57.040 --> 0:02:03.480 All South Korea has been long suffering from this doctor shortage, 0:02:03.600 --> 0:02:06.840 especially in emergency rooms and critical care, and at the 0:02:06.840 --> 0:02:10.600 beginning of twenty twenty four, we saw these resident doctors 0:02:10.720 --> 0:02:14.160 strike to protest low wages and these long working hours. 0:02:14.280 --> 0:02:16.160 This has now been going on for almost a year. 0:02:16.520 --> 0:02:20.440 At the same time, you've got this spectacular rise of 0:02:20.480 --> 0:02:23.760 the medical tourism industry, You've got a rise in doctors 0:02:23.840 --> 0:02:28.520 going into the more lucrative fields like plastic surgery, cosmetic centers, dermatology, 0:02:28.919 --> 0:02:31.800 and all of these things are booming against this backdrop 0:02:31.840 --> 0:02:35.760 where you've got people dying, people being refused from hospitals 0:02:35.800 --> 0:02:37.359 because there's a shortage of doctors. 0:02:43.040 --> 0:02:46.800 Welcome to The Big Take Asia from Bloomberg News. I'm 0:02:46.919 --> 0:02:51.120 Rebecca Chung Wilkins. Every week we take you inside some 0:02:51.200 --> 0:02:54.960 of the world's biggest and most powerful economies and the markets, 0:02:55.000 --> 0:02:59.519 tycoons and businesses that drive this ever shifting region. Today 0:02:59.560 --> 0:03:02.359 on the show, the rise of medical tourism in South 0:03:02.440 --> 0:03:06.000 Korea and how it's colliding with a shrinking supply of 0:03:06.080 --> 0:03:15.280 doctors and a struggling medical system. 0:03:15.320 --> 0:03:15.680 One. 0:03:16.080 --> 0:03:17.800 Hello, hey there, how's it going. 0:03:17.960 --> 0:03:18.360 Welcome. 0:03:18.400 --> 0:03:20.080 It's kind of funny treating seeds, isn't it. 0:03:20.160 --> 0:03:22.400 I know, so you usually sit on this end of 0:03:22.440 --> 0:03:24.720 the microphone, and finally I can put you in the 0:03:24.720 --> 0:03:27.600 hot seats. I'm going to try and spook you as much. 0:03:27.520 --> 0:03:30.480 As possible as Farry. 0:03:29.720 --> 0:03:32.440 Bloomberg's one hat is usually the host of The Big 0:03:32.480 --> 0:03:35.640 Take Asia, but this week she's in the hot seat 0:03:35.760 --> 0:03:39.440 to talk about her reporting on South Korea's medical tourism industry. 0:03:39.760 --> 0:03:43.120 Medical tourism is this broad catch all that the government uses, 0:03:43.400 --> 0:03:45.560 and it runs the gamut from people coming in for 0:03:45.640 --> 0:03:49.480 health checkups, to cancer treatment, even to laser surgery. But 0:03:49.680 --> 0:03:53.800 for most medical tourists, it's really about plastic surgery and skincare. 0:03:54.360 --> 0:03:57.480 Along with the rise of K pop, k beauty is 0:03:57.600 --> 0:03:59.760 enjoying a spectacular boom. 0:04:00.080 --> 0:04:03.000 Everything about South Korean culture is so cool and hip 0:04:03.040 --> 0:04:05.000 these days. I mean the fact that you know, Squid 0:04:05.040 --> 0:04:09.040 Games is on television, Black Pinks Rosy per song apt 0:04:09.320 --> 0:04:13.080 is like the global hit right now, playing on radios 0:04:13.280 --> 0:04:15.760 and streaming everywhere. And so of course this whole K 0:04:15.880 --> 0:04:20.719 pop culture is really feeding into this beauty esthetic. Looking young, 0:04:20.800 --> 0:04:25.040 looking good, having dewy glass skin that really is a standard, 0:04:25.080 --> 0:04:27.040 not just for Koreans, but I think for a lot 0:04:27.040 --> 0:04:28.880 of young people all around the world. 0:04:29.880 --> 0:04:33.679 Medical tourism isn't new. For years, people have been traveling 0:04:33.720 --> 0:04:37.839 to places like Thailand and Brazil for treatments, but South 0:04:37.920 --> 0:04:41.160 Korea is now seen as a rising destination for medical 0:04:41.200 --> 0:04:44.120 and cosmetic care, where people seek out some of the 0:04:44.160 --> 0:04:49.279 most affordable and advanced procedures to transform their bodies. It's 0:04:49.320 --> 0:04:52.840 a highly competitive industry and one the Korean government has 0:04:52.880 --> 0:04:55.560 been formally promoting since two thousand and nine. 0:04:55.960 --> 0:04:59.080 The Korean government really wants to establish Korea as a 0:04:59.120 --> 0:05:02.720 medical tourism hub. The lawmakers in twenty sixteen past this 0:05:02.880 --> 0:05:06.400 law to support and help grow the medical tourism industry. 0:05:06.760 --> 0:05:09.599 And it's got a whole system to basically license companies 0:05:09.680 --> 0:05:12.760 that help to bring in these foreign patients to the clinics. 0:05:12.920 --> 0:05:15.600 It gives subsidies to the companies and to the industry. 0:05:15.760 --> 0:05:18.960 There's this government unit under the Health to Ministry that holds, 0:05:19.120 --> 0:05:22.320 you know, medical tourism shows around the world, and they 0:05:22.320 --> 0:05:23.920 offer medical tourism visas. 0:05:24.279 --> 0:05:26.840 And you recently went to South Korea for one of 0:05:26.880 --> 0:05:31.080 these treatments. Maybe that's why you're looking particularly glowing in 0:05:31.120 --> 0:05:32.480 twenty thirty five five. 0:05:33.480 --> 0:05:35.839 Well, you know, as you say, while in Korea, do 0:05:35.920 --> 0:05:38.279 as the Koreans do. I mean, it's hard to be 0:05:38.400 --> 0:05:41.680 in Korea and not feel like, geez, there's something wrong 0:05:41.680 --> 0:05:44.480 with me. And I figured, since I'm writing about this, 0:05:44.880 --> 0:05:47.239 I figure I should just do it myself and experience 0:05:47.279 --> 0:05:48.479 for myself what that was like. 0:05:48.839 --> 0:05:53.320 And what did your doctor tell you in your consultation? 0:05:53.680 --> 0:05:55.599 Oh that was funny. 0:05:56.480 --> 0:05:56.640 Hi. 0:05:56.839 --> 0:06:00.320 My name is Juan yep So. I actually went to 0:06:00.360 --> 0:06:03.719 two consultations. The very first one was for the facial 0:06:03.760 --> 0:06:06.560 treatment that I got. I also went to go see 0:06:06.560 --> 0:06:09.400 a plastic surgeon and asked him what would you do 0:06:09.560 --> 0:06:12.400 to improve upon this? Here's here's what he said. 0:06:13.880 --> 0:06:17.400 And you notice it's a really cookie and your TV 0:06:17.480 --> 0:06:21.520 serve ved if Bob was here. Our foreheads are really flat, 0:06:21.800 --> 0:06:26.040 so I recommend the fatcraft to hear. Your chin is 0:06:26.080 --> 0:06:29.480 a really small and retracted, so we will recommend the 0:06:30.000 --> 0:06:32.680 chin implant war shin advancement. 0:06:33.160 --> 0:06:36.440 So essentially basically said, you shouldn't be walking out like 0:06:36.520 --> 0:06:38.719 you do every day. You really should be wearing a mask. 0:06:39.000 --> 0:06:39.240 Yeah. 0:06:39.920 --> 0:06:44.600 Yeah. 0:06:45.000 --> 0:06:48.760 One eventually got a micro needling an ultrasound therapy to 0:06:48.839 --> 0:06:52.080 help lift and tighten her skin, and she says she 0:06:52.279 --> 0:06:55.200 did feel like she was glowing afterwards and would do 0:06:55.240 --> 0:06:59.960 it again. She got her treatments in Gangna. Yes, that's 0:07:00.000 --> 0:07:03.440 it's the same Gangnam that's featured in the song Gangnam Style. 0:07:03.920 --> 0:07:06.640 Gangnam is a district in Soul and the name literally 0:07:06.720 --> 0:07:09.920 translates to south of the Han River, and it's known 0:07:09.920 --> 0:07:12.400 as South Korea's Beverly Hills actually because a lot of 0:07:12.440 --> 0:07:15.360 the wealthy residents and you've got these celebrities who live 0:07:15.400 --> 0:07:18.840 there as well, So both a residential area but also 0:07:18.880 --> 0:07:21.920 a very vibrant business district. I went on a tour 0:07:22.200 --> 0:07:25.040 and entered about five of these high rises, and every 0:07:25.080 --> 0:07:28.240 single one was filled with literally dozens and dozens and 0:07:28.240 --> 0:07:32.840 dozens of plastic surgery, cosmetic centers, skin care clinics. 0:07:33.160 --> 0:07:36.960 Based on data from the International Society of Esthetic Plastic Surgery, 0:07:37.320 --> 0:07:41.480 the number of Korean cosmetic surgeons in private practice has 0:07:41.560 --> 0:07:44.840 nearly doubled in the past decade to more than twenty 0:07:44.920 --> 0:07:50.600 seven hundred, the highest concentration per capita globally. But South 0:07:50.680 --> 0:07:54.440 Korea also has one of the lowest ratios of doctors 0:07:54.480 --> 0:07:58.280 to population in the developed world, meaning there's not enough 0:07:58.320 --> 0:08:01.800 doctors to care for people in need of medical attention. 0:08:02.320 --> 0:08:04.320 The doctors, they've been on strike for almost a year, 0:08:06.040 --> 0:08:08.680 some of them have resigned. There's a local media report 0:08:08.680 --> 0:08:11.560 that said the number of er doctors fell more than 0:08:11.560 --> 0:08:13.800 forty percent nationwide last year. 0:08:16.600 --> 0:08:20.400 After the break. Where South Korea's medical tourism boom and 0:08:20.440 --> 0:08:34.559 its doctor shortage collides. South Korea has seen a boom 0:08:34.600 --> 0:08:37.760 in medical tourism in recent years, with hundreds of thousands 0:08:37.840 --> 0:08:40.679 of people coming from around the world to get popular 0:08:40.720 --> 0:08:46.680 cosmetic treatments, but tensions are escalating alongside that growth. For years, 0:08:46.880 --> 0:08:50.119 South Korea has been plagued by a shortage of doctors, 0:08:50.440 --> 0:08:54.599 especially in critical fields, and young doctors in particular have 0:08:54.720 --> 0:08:58.760 been complaining about their low wages and harsh working conditions. 0:08:59.400 --> 0:09:02.400 Blueberg to oneh met one of these doctors. 0:09:02.880 --> 0:09:08.120 She's obgyn, an obstetrician gynecologist in her thirties, and she 0:09:08.280 --> 0:09:12.800 basically said, listen, life as a resident is awful, right. 0:09:12.920 --> 0:09:15.160 You don't make a lot of money to begin with, 0:09:15.559 --> 0:09:18.320 but you're working these crazy work weeks. She was saying 0:09:18.360 --> 0:09:20.040 that she had worked eighty hour weeks. 0:09:20.240 --> 0:09:23.280 And in February last year, to address the shortfall of 0:09:23.280 --> 0:09:28.559 medical staff, the government proposed increasing the quota for medical students. 0:09:28.720 --> 0:09:33.320 They proposed to increase medical school admissions by two thirds 0:09:33.400 --> 0:09:35.560 to about five thousand a year. You think that would 0:09:35.600 --> 0:09:38.160 be a good thing, right, getting more doctors into the pipeline, 0:09:38.200 --> 0:09:40.800 But in fact, the doctors were all up in arms 0:09:40.800 --> 0:09:41.240 about it. 0:09:43.400 --> 0:09:46.839 And why are they upset about the government increasing admissions 0:09:46.880 --> 0:09:48.000 for medical students. 0:09:48.320 --> 0:09:51.080 The doctors are saying that, hey, just adding more doctors 0:09:51.080 --> 0:09:54.040 into the mix isn't going to solve the structural problems 0:09:54.120 --> 0:09:57.800 that's really underpinning the shortage and it comes down to 0:09:57.840 --> 0:10:00.960 what they say, or at least two critical issue shoes. One. 0:10:01.360 --> 0:10:05.319 Korea's got this great national health insurance system. It serves 0:10:05.360 --> 0:10:08.320 fifty two million citizens. It's one of the best healthcare systems. 0:10:08.679 --> 0:10:12.080 But Koreans love to see their doctors, and they're seeing 0:10:12.120 --> 0:10:14.960 their doctors way more than in other developed countries. So 0:10:15.080 --> 0:10:16.920 these doctors are super super busy. 0:10:18.240 --> 0:10:22.360 That's in part because healthcare is really accessible and affordable 0:10:22.400 --> 0:10:27.040 in South Korea. Koreans can visit any medical institution, public 0:10:27.120 --> 0:10:30.080 or private, and only need to pay a fraction of 0:10:30.120 --> 0:10:35.079 the cost. The government then reimburses the hospitals and clinics 0:10:35.160 --> 0:10:39.840 for the treatment. But hospitals say the reimbursement from the 0:10:39.920 --> 0:10:41.600 government is too low. 0:10:41.880 --> 0:10:44.319 So low in fact, that a lot of these hospitals 0:10:44.360 --> 0:10:48.360 are barely financially stable and they're relying on this very 0:10:48.400 --> 0:10:51.000 heavy and high turnover to stay in business. And of 0:10:51.000 --> 0:10:53.600 course that puts a lot of burden back on the doctors, 0:10:53.760 --> 0:10:57.679 especially these poor young residents who are working crazy eighty 0:10:57.720 --> 0:10:58.680 work week hours. 0:10:59.000 --> 0:11:03.000 In February twenty two, twenty four, nearly thirteen thousand doctors, 0:11:03.200 --> 0:11:07.800 mostly residents and trainees, went on strike around the country. 0:11:07.920 --> 0:11:11.559 Some of them have resigned altogether. The strike has been 0:11:11.600 --> 0:11:16.480 going on for almost a year. The guynecologist she also 0:11:16.640 --> 0:11:19.240 joined the walkout with her colleagues and has since quit 0:11:19.320 --> 0:11:22.400 her job at the hospital. She's now working as a 0:11:22.400 --> 0:11:26.160 dermatologist at a skincare clinic and soul. She said she's 0:11:26.240 --> 0:11:29.120 happy with that choice now that she can spend more 0:11:29.160 --> 0:11:30.240 time with her baby. 0:11:30.440 --> 0:11:33.640 There are just these fundamental structural problems that the government 0:11:34.000 --> 0:11:36.880 still isn't addressing, and so you do have doctors leaving 0:11:36.880 --> 0:11:40.840 critical medical specialties and entering fields that aren't dependent on 0:11:40.880 --> 0:11:45.320 the healthcare reimbursement system, like dermatology, like plastic surgery. 0:11:45.240 --> 0:11:49.760 For things like cosmetic procedures or plastic surgery, such treatments 0:11:49.920 --> 0:11:53.640 aren't covered by national insurance, so doctors working in these 0:11:53.679 --> 0:11:57.800 specialties are able to charge and earn a lot more. 0:11:57.960 --> 0:11:59.960 The doctors say, as long as you have this current 0:12:00.120 --> 0:12:03.480 national health insurance system in place with super low reimbursements, 0:12:03.760 --> 0:12:06.040 you're always going to have a shortage of doctors because 0:12:06.080 --> 0:12:08.760 nobody's going to want to stay in these critical care 0:12:09.160 --> 0:12:12.080 specialties that don't pay a whole lot when they can see, oh, 0:12:12.160 --> 0:12:15.720 they're fellow dermatologists making twice as much as they are. 0:12:15.800 --> 0:12:19.880 Even more, the impasse has led to a disruption of 0:12:19.960 --> 0:12:24.320 essential medical services at hospitals. Major hospitals have had to 0:12:24.360 --> 0:12:29.360 cut back on surgeries and emergency room operation hours. In 0:12:29.400 --> 0:12:34.439 some cases, the shortage has had deadly consequences. A report 0:12:34.559 --> 0:12:39.040 from Dunguok University said some thirty seven hundred patients have 0:12:39.320 --> 0:12:43.920 died since twenty seventeen because local hospitals didn't have enough 0:12:44.040 --> 0:12:49.760 doctors to treat patients and refused to provide care. After 0:12:49.800 --> 0:12:53.840 the walkout, the Health Ministry began deploying military doctors to 0:12:53.920 --> 0:12:58.800 hospital emergency rooms to deal with the ongoing staff shortage 0:12:58.840 --> 0:13:01.280 and in the long run, the government told Bloomberg, GET 0:13:01.320 --> 0:13:04.360 pledged to spend about twenty billion dollars to complete medical 0:13:04.360 --> 0:13:08.800 reform and is continuing to monitor the situation. There's another 0:13:08.880 --> 0:13:12.240 consequence to all of this. It's impossible to ignore, and 0:13:12.320 --> 0:13:14.440 you can see it on the faces of people you 0:13:14.480 --> 0:13:16.600 pass on the street in Korea and beyond. 0:13:17.120 --> 0:13:21.040 It's hard because in Korea when you walk around, everybody 0:13:21.080 --> 0:13:24.120 is put together right, And can you imagine if you 0:13:24.160 --> 0:13:26.800 don't subscribe to that kind of esthetic, If that's not 0:13:26.960 --> 0:13:29.480 you right, I mean, how out of place you feel 0:13:29.520 --> 0:13:31.920 and when there are places that are offering six dollars 0:13:31.920 --> 0:13:35.439 botox shots, how can you refuse? And so I think 0:13:35.480 --> 0:13:39.280 there is such an immense pressure for people to stay young, 0:13:39.440 --> 0:13:41.720 to look young, to stay good, and I think it's 0:13:41.720 --> 0:13:45.200 really hard for people who perhaps don't subscribe to that 0:13:45.280 --> 0:13:48.680 kind of aesthetic and value. 0:13:49.720 --> 0:13:52.400 One checked in with Julie, the women from New Jersey 0:13:52.480 --> 0:13:54.840 that we heard earlier a month and a half after 0:13:54.880 --> 0:13:55.760 her procedures. 0:13:56.160 --> 0:13:57.520 So how are you doing? You said, a lot of 0:13:57.520 --> 0:14:01.840 people were noticing made some nice comments about your face 0:14:01.880 --> 0:14:02.320 and skins. 0:14:02.360 --> 0:14:06.359 Well, yeah they did. They said that I'm aging backwards. 0:14:06.440 --> 0:14:06.920 That's great. 0:14:07.000 --> 0:14:08.600 Well, how do you feel about it? 0:14:09.720 --> 0:14:12.200 I don't know that I noticed much until a couple 0:14:12.200 --> 0:14:14.679 of weeks. And then a couple of weeks later, at 0:14:14.679 --> 0:14:16.760 some point I looked in the mirror and I was like, Oh, 0:14:16.960 --> 0:14:18.280 my skin is looking really good. 0:14:18.520 --> 0:14:21.040 Are you thinking about making another trip anytime soon? 0:14:21.280 --> 0:14:23.320 I would actually do it, like in a year. 0:14:23.440 --> 0:14:25.880 Yeah. Are you thinking next time you'll come back with 0:14:25.960 --> 0:14:28.080 a friend, or you'll come back by yourself, or what 0:14:28.120 --> 0:14:28.600 are you thinking? 0:14:29.520 --> 0:14:33.760 My sister in law seems really interested, So maybe. 0:14:39.840 --> 0:14:43.120 This is the big take. Asia from Bloomberg News I'm 0:14:43.280 --> 0:14:47.680 Rebecca Cheung Wilkins. This episode was produced by Young Young, 0:14:47.840 --> 0:14:51.600 Naomi Ung, and Jessica Beck. It was mixed by Alex Sagura, 0:14:51.840 --> 0:14:55.320 sound designed by Jessica, and fact check by Naomi. It 0:14:55.360 --> 0:14:58.480 was edited by Aaron Edwards and David Rocks. There was 0:14:58.520 --> 0:15:03.040 additional reporting Guy Sella. Naomi Shavin is our senior producer, 0:15:03.360 --> 0:15:07.120 Elizabeth Ponso is our senior editor, Nicole Beemsterbor is our 0:15:07.160 --> 0:15:11.320 executive producer, and Stage Bauman is Bloomberg's head of podcasts. 0:15:11.880 --> 0:15:15.400 Please follow and review The Big Take Asia wherever you 0:15:15.440 --> 0:15:19.600 listen to podcasts. It really helps new listeners find the show. 0:15:20.280 --> 0:15:21.200 See you next time.