Between credit claiming and blame avoidance: The changing politics of priority-setting for Korea's National Health Insurance System

Minah Kang, Michael R. Reich

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Priority-setting involves diverse parties with intense and often conflicting interests and values. Still, the political aspects of priority-setting are largely unexplored in the literature on health policy. In this paper, we examine how policy makers in Korea changed their strategies as the policy context for priority setting changed from only expanding benefits to a double burden of benefit expansion plus cost containment.This analysis shows that priority-setting is a profoundly political process. The policy context shapes how policy makers choose their political strategies. In particular, we find that policy makers sway between "credit claiming" and "blame avoidance" strategies. Korean policy makers resorted to three types of political strategies when confronted with a double burden of benefit expansion and cost containment: delegating responsibility to other institutions (agency strategies), replacing judgment-based decisions with automatic rules (policy strategies), and focusing on the presentation of how decisions are made (presentational strategies). The paper suggests implications for future studies on priority-setting in the Korean health care system and in other countries that face similar challenges, and concludes that Korean policy makers need to put more effort into developing transparent and systematic priority-setting processes, especially in times of double burden of benefit expansion and cost containment.

Original languageEnglish
Pages (from-to)9-17
Number of pages9
JournalHealth Policy
Volume115
Issue number1
DOIs
StatePublished - Mar 2014

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea Grant funded by the Korean Government ( NRF-2010-013-B00048 ).

Keywords

  • Blame avoidance
  • Credit claiming
  • Health politics
  • Health system governance
  • Priority-setting

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