Governing universal health insurance in Korea and Taiwan

This article examines policy responses to the rising costs of healthcare in the Republic of Korea and Taiwan from a governance perspective. It tries to answer why the two countries responded differently to a similar set of challenges facing their National Health Insurance (NHI). While Taiwan – in an attempt to contain costs – introduced a global budgeting system, Korea failed to do so. Governments in both countries attempted to establish a new mode of governance, bringing multiple stakeholders to health policy making in order to build social consensus. But the Korean government, as this article shows, could not resolve its policy deadlock because of a loss of trust between the government and the medical profession, caused by the separation reform of 2001. Even though Taiwan was better able than Korea to address the financial challenges of its NHI, the new mode of health governance is still on shaky ground. This article argues that because neither government now enjoys the exclusive power over health policy that they once did under the developmental state, it is essential to find a way in which different stakeholders can make the necessary compromises that will enable the NHI to run on a sustainable path for the future.