The origins and implementation of the national health insurance programs in Korea, 1961-1979

This study examines the health politics of the Korean National Health Insurance Act in 1963 and in 1977. The 1963 NHI Act was the first voluntary health insurance act in Korea and resulted in only a few pilot programs. The 1977 NHI Act was the first successful compulsory health insurance program for large firms with more than 500 employees and their dependents. The study expands the welfare state theory by reflecting the historical institutional contexts of Korea. Most of the welfare state studies have been conducted using advanced societies that have had social democratic traditions and/or labor movements. Korea’s National Health Insurance Act of 1963 and 1977 were initiated by a strong state government with limited participation from interest groups of business and medical professions and labor. This study has four key findings. 1) The administrative capacity of the state was the major factor that drove the successful implementation of Korea’s 1977 National Health Insurance Act. The state established an advanced bureaucratic system with welldisciplined bureaucrats. The source of the state capacity was not from financial resources, but from an effective administration that was based on state autonomy and centralized power of President Park. 2) Interest groups did not have a strong resistance