Democratization, Agenda-Setting, and the Regulation of Health-Care Professionals: Pharmaceutical Regulation in Korea

Abstract

This article examines how political democratization shapes the regulation of professional interest groups by focusing on agenda-setting processes. It investigates the case of the separation of prescribing and dispensing (SPD) in South Korea—an intricate health-care reform involving doctors, pharmacists, and the state. Despite the SPD being a complex issue beyond lay understanding, the study reveals how democratization facilitated its implementation by enabling the entry of reform-oriented actors into the policy network. Drawing on documentary analysis and 36 interviews with key stakeholders, the study contrasts two periods: the early 1980s, when an authoritarian regime adopted a liberal approach but withdrew the SPD amid resistance, and the late 1990s, when a democratic government enforced the SPD using legal instruments, despite fierce opposition from doctors. The article argues that democratization reconfigures the agenda-setting arena by allowing excluded actors—such as progressive professionals and civic organisations—to articulate hidden policy problems in ways that mobilise public opinion and compel political elites to act. While these actors may not dominate subsequent policy-making, their agenda-setting role proves decisive. The findings contribute to debates on state capacity, interest group regulation, and the substantive effects of democratic inclusion on policy processes.