This study is to analyze the reason of Breakdown of collective bargaining caused by the difference of main issue about bargaining and other factors influencing collective bargaining from the viewpoint of both labor and capital in Korean medical system. Korean medical system is facing the huge change of medical policy, so it should pursue institutional change following the change of medical system, On the contrary, the activity of labor union in medical system is more organized, activated, so understanding and cooperating on the related policy between labor and management are necessary. As the method of administration participation is collective bargaining, main issues between labor and management may lead Brwakdown of bargaining, so the author will analyze it from three viewpoints. First, the difference of recognition between labor and management due to the characteristics of hospital Secondly, the difference of recognition between labor unions due to the characteristics of hospital Thirdly, the difference of recognition between the characteristics of hospital and labor union.