North Korea continues to promote its free healthcare system as a symbol of socialism’s strength. However, citizens describe a very different reality. Many say the system provides no real treatment and little access to medicine. As a result, North Koreans rely heavily on the black market to survive.
Hospitals often lack proper equipment and essential medicines. People believe only imported drugs offer real solutions for illness. Moreover, the state itself recently admitted that foreign-made medications treat seasonal diseases such as enteritis and food poisoning. Therefore, many residents see the black market as their only hope for recovery.
Russian-made medicines dominate the market. About 70 percent of imported drugs come from Russia, often shipped by state trading firms. Kumgang Trading Corporation and Ponghwa General Trading Corporation handle large volumes of these imports. In addition, Chinese medications reach state hospitals, but many citizens remain skeptical of their effectiveness.
The imported drugs flow first to major hospitals in Pyongyang, military facilities, and sanatoriums for officials. However, much of this supply eventually leaks into markets across the country. Merchants sell them without licenses, creating widespread trade in unregulated medicine. Furthermore, locals often buy drugs based on word of mouth since labels appear in foreign languages.
People trust Russian drugs far more than Chinese products. They believe Russian medicine works faster and more reliably. Merchants reinforce this belief by promoting these drugs as instant cures. Consequently, demand for Russian imports keeps rising. Citizens continue spreading positive reviews, which fuels even greater interest in these products.
Locally produced medicines inspire little confidence. State factories like Sunchon Pharmaceutical Factory and Hamhung Pharmaceutical Factory manufacture drugs, but people doubt their effectiveness. Citizens often say the free healthcare system cannot be trusted. Instead, they rely on foreign-made drugs sold in markets, even at high prices.
Residents admit that the state’s free healthcare system is largely meaningless. They argue that survival requires money and access to imported medicine. “You can endure hunger, but you cannot endure illness,” said one resident. Therefore, many want the government to allow broader foreign trade in medicine, even if it requires paying directly.
Ultimately, the North Korean free healthcare system exists more in rhetoric than in reality. Citizens depend on unlicensed markets for medicine and distrust state hospitals. This dependence exposes the gap between propaganda and daily life. Moreover, it highlights how survival often relies on trade networks rather than state promises.
