The Korean Welfare state and Productivist Welfare Capitalism: A Historical Analysis of the Korean National Health Insurance System
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This study examined Korea’s National Health Insurance (KNHI) in order to assess whether Korea’s recent welfare developments have weakened the productivist welfare regime thesis characterizing East Asian countries. By using a revised version of Twaddle’s typology of national healthcare systems (professional, communal, market, and technocratic organizations), the study identified three phases in KNHI’s history of institutional changes: KNHI experienced institutional changes from a technocratic organization established under the authoritarian political regimes to another via a short period of communal organization adopted under the condition of foreign exchange crisis of 1997. Although the second technocratic organization had some elements of communal system, it is difficult to say that KNHI’s communal elements in particular and Korea’s recent welfare developments in general were accompanied by fundamental changes in the pre-existing welfare regime. The establishments such as government-led and only partially open policy process, economy-first policy orientation, tightly controlled state welfare expenditure, etc. have virtually remained intact. In short, KNHI, as a critical case, supports the proposition that the productivist regime thesis is still valid in the East Asian context.
Abstract
This study examined Korea’s National Health Insurance (KNHI) in order to assess whether Korea’s recent welfare developments have weakened the productivist welfare regime thesis characterizing East Asian countries. By using a revised version of Twaddle’s typology of national healthcare systems (professional, communal, market, and technocratic organizations), the study identified three phases in KNHI’s history of institutional changes: KNHI experienced institutional changes from a technocratic organization established under the authoritarian political regimes to another via a short period of communal organization adopted under the condition of foreign exchange crisis of 1997. Although the second technocratic organization had some elements of communal system, it is difficult to say that KNHI’s communal elements in particular and Korea’s recent welfare developments in general were accompanied by fundamental changes in the pre-existing welfare regime. The establishments such as government-led and only partially open policy process, economy-first policy orientation, tightly controlled state welfare expenditure, etc. have virtually remained intact. In short, KNHI, as a critical case, supports the proposition that the productivist regime thesis is still valid in the East Asian context.
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