Interest Groups, Discourse, and Politics of Policy Evolution: A Case Study on South Korea's Health Care Policy, 1998–2001

Abstract

The political dynamics of South Korea's health care policy has changed in significant ways since the 1990s. In particular, various interest groups in South Korea, such as medical doctor and pharmacist groups, and hospital associations have succeeded in forcing their issues onto the agenda. How have those interest groups been able to achieve this increase of influence? To answer this question, this study utilizes studies of problem definition and agenda setting. In particular, adopting Schattschneider's notion about conflict expansion and issue definition, this paper examines how the use of argument shapes the debate over South Korea's health care reform issue. The results show several important aspects of the lobbying process and its impact on the health care reform policy. First, interest groups in Korea have become active in promoting certain arguments or issue definitions, and in producing, publicizing, or providing evidence that supports these arguments. This strategy may affect policy outcomes by refocusing legislator attention or by mobilizing symphathetically‐disposed members to utilize their legislative agency's power in pursuit of the groups' policy goals. Second, interest group lobbying activity is a conflictual and dynamic process. Opponents of the Health Care Reform initiated their lobbying activities and expanded the scope of conflict by focusing on certain issue dimensions. Faced with interest groups politicizing a conflict, proponents of the new program must react. Thus, the lobbying process is a reactive and conflictual process by which interest groups compete for political influence through the issue definitions, arguments, and evidence they present in order to shape the policy‐making process. In the case examined for this study, the KMA, an opponent of a given policy proposal, seemed to succeed in getting their issues onto the agenda by appealing to a large audience and expanding the scope of conflict. By so doing, they were able to shape the final policy process.