The Co-evolution of Politics and the Healthcare System in South Korea

A key structural characteristic of the Korean medical system is that the public share of total medical expenditure is low, and the provision of medical services relies primarily on the private sector. These structural characteristics emerged within the context of World War II, the end of the war, the Cold War system, and the expansion of global neoliberalism. Even amidst colonialism, authoritarian regimes, and the abuses of development-oriented governments, there were counter-movements that resisted through independence, democratization, and the strengthening of public services. In this process of co-evolution, specific policies related to the healthcare system often became the concrete manifestations of this struggle. The partial achievements attained by civil society and labor movements—such as the establishment of workers’ hospitals, the integration of health insurance, and the prevention of healthcare privatization—were made possible by progress in the broader context of independence and democratization. Currently, the Korean healthcare system is facing three major crises: (1) constant pressure for privatization and commercialization of healthcare services, (2) sustainability of the healthcare system amid rapid aging, and (3) explosive growth of science and technology driven by artificial intelligence (AI) and the resulting weakening of civil, labor, and social rights. The outcome of the new crisis currently facing South Korea’s healthcare system will also be determined by the multilayered political dynamics between dominant and countervailing forces at the global, national, and collective levels. The history of co-evolution between politics and the healthcare system that South Korean society has built thus far will provide useful insights not only for Korea but also for other nations facing similar situations in their efforts to establish better healthcare systems.