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Kang M, Reich MR. Between credit claiming and blame avoidance: the changing politics of priority-setting for Korea's National Health Insurance System. Health Policy. 2013;115(1):9-17doi: 10.1016/j.healthpol.2013.09.015.
Kang, M., & Reich, M. R. (2014). Between credit claiming and blame avoidance: the changing politics of priority-setting for Korea's National Health Insurance System. Health policy (Amsterdam, Netherlands), 115(1), 9-17. https://doi.org/10.1016/j.healthpol.2013.09.015
Kang, Minah, and Reich, Michael R. "Between credit claiming and blame avoidance: the changing politics of priority-setting for Korea's National Health Insurance System." Health policy (Amsterdam, Netherlands) vol. 115,1 (2014): 9-17. doi: https://doi.org/10.1016/j.healthpol.2013.09.015
Kang M, Reich MR. Between credit claiming and blame avoidance: the changing politics of priority-setting for Korea's National Health Insurance System. Health Policy. 2014 Mar;115(1):9-17. doi: 10.1016/j.healthpol.2013.09.015. Epub 2013 Oct 08. PMID: 24176287.
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Health Policy. 2014 Mar;115(1):9-17. doi: 10.1016/j.healthpol.2013.09.015. Epub 2013 Oct 08.

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

Health policy (Amsterdam, Netherlands)

Minah Kang, Michael R Reich

Affiliations

  1. Department of Public Administration, College of Social Sciences, Ewha Womans University, Seoul, Republic of Korea.
  2. Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. Electronic address: [email protected].

PMID: 24176287 DOI: 10.1016/j.healthpol.2013.09.015

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.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Keywords: Blame avoidance; Credit claiming; Health politics; Health system governance; Priority-setting

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