Kim Jong Un’s latest appearance, in which he dressed down officials building a showcase hospital, illustrates why the North Korean leader can’t afford to languish under sanctions forever if he wants to fix his economy.

In a visit to the Pyongyang General Hospital, Kim lashed out at the building committee over "serious problems in economic organization for the construction,” the official Korean Central News Agency said Monday. Kim "rebuked” the committee for not following ruling party policies and accused it of "careless” budgeting.

The tense field inspection comes less than three months before the 75th anniversary of the Workers’ Party of Korea on Oct. 10, which Kim in March had chosen as a symbolic completion date. The project appears to have been hit by a shortage of building materials, underscoring the difficulty he faces to improve living conditions while toiling under a U.S.-led sanctions campaign designed to curb his nuclear program.