Rural Medicine and the Farmers' "Right to Health" in 1980s South Korea: The Rural Health Insurance and the Health Insurance Reform Movement.

Authors

Dahye Jeong

Published in

Ui sahak. Volume 35. Issue 2. Pages 635-688.

Abstract

The history of Korean health security is usually told as a compressed achievement, from workplace insurance in 1977 to universal coverage in 1989 and unified National Health Insurance in 2000. Departing from that framework, this article places the Rural Health Insurance of 1988, which extended coverage to farming and fishing villages, within the longer history of rural medical marginalization since liberation, in which the equitable distribution of medical care remained an unmet task across regimes. It asks how farmers' health briefly emerged as a social category and was then reduced to a dispute over insurance administration. The program rested on weak foundations. Rural facilities built up since the late 1970s functioned poorly, and the regional-insurance pilots begun in 1981 had stalled under chronic deficits by 1985. Implementation was nevertheless advanced to 1988 amid agrarian crisis and the pressures of democratization. Resistance was immediate and widespread, the first occasion on which the affected population itself demanded institutional reform. Farmers contested not only premiums but their assessment, referral districts imposed on a scarce supply, the undemocratic insurance societies, and the hazards of farm labor, from pesticide poisoning to "farmer's syndrome," which lay outside the industrial accident insurance covering wage workers. Joined by health professionals and the urban poor, these grievances were articulated as a claim to a "right to health." The claim receded almost as quickly. The article attributes the retreat to conditions rather than movement failure: a coalition of such breadth required a common agenda, and the administration of insurance determines how contributions are levied and pooled, not where medical care exists. Concentration on integration was reasonable under those conditions, yet it left the distribution of medical resources and farmers' health unaddressed. Universal coverage is read here not as a completed institution but as the history of a problem posed, transformed, and unresolved.

PMID:
42823810
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.

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