Universal but Precarious: A Case Study of South Korean Health Care System
Since its inception in 1977, the development of the National Health Insurance system in South Korea took the world by surprise. In 2001, South Korea introduced a single-payment system. However, in spite of the advancements made in medical technology and services and the fact that the National Health Insurance system covers the whole population, its citizens are seemingly still insecure and often experience precariousness with regard to their health coverage. It is ironic that despite the nearly 100% population coverage, many South Koreans also purchase private health insurance because of their anxiety about the limited coverage of the National Health Insurance benefit package. Even though the health care system in South Korea displays symptoms of precariousness, there is still no academic research that analyzes this concept as an approach to understanding the challenges that face the system. In this study, we examine the suitability of applying three attributes of precariousness, namely uncertainty, disempowerment, and insecurity (both financial and institutional), previously researched in the employment sector, to the health system to analyze how South Koreans experienced them and to explain the precariousness of the health care system at both the individual and institutional levels.