The origins and implementation of the national health insurance programs in Korea, 1961-1979

Abstract

This study examines the health politics of the Korean National Health Insurance Act in 1963 and in 1977. The study expands the welfare state theory by reflecting the historical institutional contexts of Korea. Korea's National Health Insurance Act of 1963 and 1977 were initiated by a strong state government with limited participation from interest groups of business and medical professions and labor. This study has four key findings. 1) The administrative capacity of the state based a centralized bureaucracy and state autonomy was the major factor that drove the health politics of the 1963 and the 1977 NHI policies. 2) Interest groups-business, medical professions, and labor-did not have a strong resistance against NHI policies. 3) Korean culture supported the strong state and gave the responsibility to the individuals and businesses with welfare concerns. 4) The state actively engaged in implementing social policies where it faced legitimacy crisis in the 1960s and the 1970s due to political turmoil.