Where’s the beef?: the politics of health care reform in South Korea

Abstract

Background: In February 2024, the South Korean government released a policy proposal for healthcare reform, with one of the main pillars being increased medical school admissions. This policy has sparked intense opposition from the physicians’ top association. Most importantly, interns and residents—the bedrock of the medical workforce in Korean hospitals—began to leave en masse. Consequently, a medical crisis emerged, in which many medical and surgical procedures were delayed.Current Concepts: According to studies on comparative health policy and systems, the crisis could be attributed to the unique characteristics of the Korean healthcare system, in which the administration and doctors have failed to establish a substantive dialogue through which policy options are examined and deliberated. These dynamics necessitated the establishment of an institutional space for interest group politics, causing both to suffer from a lack of action repertoires. The stalemate we witness reflects the enduring patterns of the same issue.Discussion and Conclusion: To ensure the success of the current initiative, institutional arrangements must be established in which policymakers and physicians make a credible commitment to each other. Alternatives, for instance, include reactivating and regularizing the Health and Medical Services Policy Deliberation Committee, which could pave the way for establishing a venue where key stakeholders can discuss future agendas, such as how to ensure improved accessibility to “essential” care and mitigate its subnational variation, thereby creating a long-term vision for new health system governance in South Korea.