The Role of NGOs in Korean Health Care Reform in 2012: An Advocacy Coalition Framework Perspective

South Korea is well known for its successfully operating National Healthcare Insurance (NHI) system which was first implemented in 1977 as state initiated healthcare system for the workers, then was extended as to establish universal healthcare system in 1989. Even with the achievement of nationwide universal health care since 1989, there is a growing concern for its budget deficit in the near future, which would be caused mainly by extremely low birth rate and rapid population ageing of Korean society. Reform of health care payment system based on FFS (Fee-for-service) had been a longtime issue of Korean health care policies since 1994, when health care budget problem was first raised by health care policy actors. However, Korean government failed to implement DRG (drug-related group) payment system in 2002 and 2004 due to strong resistance of physicians and medical interest groups. With almost two decades of conflicts and debates within the nation, eventually, Korean government could implement DRG payment system for seven disease groups in 2012. For the successful implementation of the system, Korean government strategically embraced NGOs which had long been supporting payment system reform policy. However, the NGOs, which had made coalition with Korean government concerning health care reform issue, had been known for their anti-governmental activities in many social policies and issues. And furthermore, Lee Myung-Bak government, which had successfully launched DRG system in Korea, was one of the least friendly governments to rather progressive Korean NGOs who supported DRG system. This research explains how Korean government worked to make a coalition group with NGOs to successfully implement health care reform, with the perspective of advocacy coalition framework. In conclusion, it has proven that above two political actors have shared their policy core beliefs in the policy process of DRG payment reform in Korea.