CHANGWON — Hospital ships that provide medical care and vaccinations to about 34,000 island residents are not legally recognized as medical institutions. Because they cannot access the government's health care system and local governments bear their operating costs, calls are growing to clarify their legal status and expand state support.
Four regional governments — South Gyeongsang Province, Jeonnam-Gwangju, Incheon and South Chungcheong Province — operate five hospital ships that handle medical care and health management for 34,066 residents across 257 islands, according to South Gyeongsang Province on the 6th.
Of the 480 inhabited islands nationwide as of the end of 2024, only 192 had health care facilities other than pharmacies, according to the National Assembly Research Service. That is why many island residents have little choice but to rely on mobile medical services such as hospital ships.
Hospital ships are also essential for vaccinations. Starting on the 6th, South Gyeongsang Province is offering free influenza shots to 593 residents of 21 island villages in Tongyeong, Sacheon, Goseong and Hadong. The province's hospital ship will make 120 voyages this year, providing medical, dental and traditional Korean medicine services in 51 island villages.
Despite this central role, the legal status of hospital ships remains unclear. They operate under a Ministry of Health and Welfare directive and local ordinances, which means they are not recognized as regional public health institutions and cannot use the government's health care system. The National Assembly Research Service noted that while a revision to the Medical Service Act in December institutionalized telemedicine, hospital ships were excluded because they have no legal status.
Operating costs also fall on local governments. Construction of a new hospital ship for South Gyeongsang Province, which begins service in March next year, cost 15 billion won ($10.5 million), including 10 billion won from the central government, but state funding is limited to design, construction and repair expenses. Fuel accounted for 60.5% of the 4.59 billion won spent nationwide on hospital ship operations last year, yet the vessels are excluded from tax-free fuel programs. South Gyeongsang Province budgeted this year's fuel costs of 228.69 million won entirely from provincial funds.
Efforts to change the rules are underway. The South Gyeongsang Provincial Council in September proposed a resolution calling for revisions to the Regional Public Health Act and two other laws known collectively as the "hospital ship three laws." Related bills that were scrapped in the 21st National Assembly have been reintroduced in the 22nd. A proposed revision to the Restriction of Special Taxation Act that would exempt hospital ship fuel from value-added tax and other levies is pending before a legislative review subcommittee.
Some lawmakers remain cautious, warning that extending tax-free fuel could spread to other local public services and raise questions of fairness. The resulting revenue loss is estimated at 800 million won a year on average. "We need to clarify the legal status of hospital ships and establish a stable system of state support," said Kim Chang-woo, a member of the South Gyeongsang Provincial Council.
