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Divergence in the development of public health insurance in Japan and the Republic of Korea: A multiple-payer versus a single-payer system
Article first published online: 4 APR 2012
DOI: 10.1111/j.1468-246X.2012.01428.x
© 2012 The author(s). International Social Security Review © 2012 International Social Security Association
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How to Cite
Jeong, H.-S. and Niki, R. (2012), Divergence in the development of public health insurance in Japan and the Republic of Korea: A multiple-payer versus a single-payer system. International Social Security Review, 65: 51–73. doi: 10.1111/j.1468-246X.2012.01428.x
Publication History
- Issue published online: 4 APR 2012
- Article first published online: 4 APR 2012
- Abstract
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Keywords:
- health insurance;
- political aspect;
- method of financing;
- scope of coverage;
- Japan;
- Republic of Korea
Abstract
Japan and the Republic of Korea achieved universal health insurance coverage for their populations in 1961 and 1989, respectively. At present, Japan continues to operate a multiple-payer social health insurance system, while the Republic of Korea has moved to an integrated single-payer national health insurance structure. This article analyzes the influence of political economy in shaping the policy divergence found between these two Bismarckian health insurance systems. Issues addressed include differences in political power, the policy influence of business, the extent to which regional autonomy has developed and regional traits have been preserved, the level of political democratization, the form of political leadership, and the scale of development of the health insurance system. The article offers policy lessons derived from the two countries' experiences.