Bill Enabling 119 Selective Patient Transfer Passes National Assembly

An Era Where 119 Chooses the Emergency Room Is Coming

A bill aimed at preventing deaths of emergency patients shuttling from hospital to hospital has cleared the National Assembly plenary session. The emergency medical services legislation, designed to end the so-called 'emergency room carousel,' passed the National Assembly on the 2nd. At its core is a system in which 119 ambulance crews designate in advance a medical facility suited to the patient's condition and transport them there. Until now, ambulance crews only learned of a hospital's refusal upon arrival at the emergency room and had to search for the next hospital — while golden time slipped away.

Why It Was Needed Now

Behind the bill lie repeated tragedies. Case after case of critically ill emergency patients dying after spending hours touring dozens of hospitals brought the structural flaws of the emergency medical system into focus as a social issue. Hospitals with emergency rooms are in chronically short supply, and regional emergency medical centers capable of treating critical patients are limited in number across the country. In certain fields such as obstetrics and pediatric emergency care, some regions have no capacity at all. Experts in the medical community and academia have long pointed out that having nowhere to send a patient is not a problem of individual doctors but of the system itself.

In particular, as the exodus of medical residents intensified following the 2024 increase in medical school admissions, emergency room operations were disrupted for prolonged periods, broadening the recognition that patient safety cannot be guaranteed without overhauling the transfer system. The bipartisan consensus on the need for legislation has now materialized with this passage.

Key Provisions

The centerpiece of the bill is establishing a legal basis for the so-called 'selective transfer' system, in which 119 designates the medical facility that will accept a patient. Fire and health authorities will work in tandem to determine in advance which medical facility a patient should be transferred to based on severity, and ambulance crews will transport patients accordingly. In areas underserved by emergency care, a detour transfer system will also be established to take critical patients directly to top-tier facilities such as regional emergency medical centers. The bill also calls for the competent authorities to monitor and share emergency medical information in real time, allowing ambulance crews to check how many critical patients each hospital can still accommodate.

Those covered by the law include emergency medical facilities and 119 paramedics nationwide, as well as the fire and health authorities commanding them. On the ground, transport will proceed immediately at the discretion of ambulance crews, and there has also been discussion of penalties to prevent hospitals from refusing transfers of critically ill emergency patients without just cause.

The Debate and Market Impact

Support was overwhelming during the National Assembly review, but practical concerns remained. Some in the medical community noted that forcing designated transfers when hospitals lack the capacity to accept patients could worsen emergency room overcrowding. Others pointed out that if the information system is inaccurate, patients could ultimately be sent based on trust in data rather than people. On the other hand, emergency medicine experts argued that whether patients move knowing their destination or not makes a clear difference in survival rates, making the introduction of the system inevitable. Civic groups also welcomed the legislation for securing patients' right to mobility and to life.

From an industry perspective, the passage is expected to boost demand for emergency medical informatization. Sharing real-time bed and severity data requires building and maintaining a nationwide emergency medical information system. Demand for related system construction projects as well as ambulances and transport equipment is also expected to rise.

Timeline and Outlook

The bill, having passed the plenary session, will go to the government and take effect upon promulgation. However, for the selective transfer system to actually function, considerable preparation time is needed: subsidiary legislation by the National Fire Agency and the Ministry of Health and Welfare, standards for calculating each facility's capacity, and construction of the information system. Experts broadly agree that rushing implementation without consulting the medical community could heighten confusion on the ground. Ultimately, the success of this law hinges not on its wording but on securing the medical workforce to staff emergency rooms. No matter how sophisticated the system, the hospital carousel will not disappear if there are no hospitals to take the patients in.