Health Care Reform Under Progressive Governments in Korea; and Late Life Inequality in Health, Work, and Economic Resources in Korea
This seminar will feature two presentations: an attempt to evaluate the impact of health policy under a decade of progressive governments in Korea; and an investigation into the health and economic well-being of the elderly in Korea. The presenters will be Dr. Byongho Tchoe, a 2008-09 visiting scholar at Stanford University, and Dr. Young Kyung Do, the inaugural postdoctoral fellow in the Asia Health Policy Program at Stanford.
Korea achieved universal health care coverage in 1989 only twelve years after the introduction of social health insurance under an authoritarian government. In 1992 a civil government won the presidential election. Consistent with a conservative ideology oriented toward market principles and globalization, that government emphasized competitive principles in health care policy. However, at the end of 1997 in the face of economic crisis, the progressive party won the Korean presidential election; their health emphasized strengthening equity, redistribution, and regulation of providers’ rent seeking behavior. Under successive progressive governments from 1998 to 2007, ambitious health policy reforms integrated insurers, separated prescribing from dispensing, reformed provider payment, expanded benefits coverage, increased medical-aid enrollees, and increased the role of government providers in the health care market. But in the election of 2007, they were defeated by a conservative party, which insists that competition among insurers and providers will enhance efficiency and quality in health care, and stresses consumer choice and responsibility.
Dr. Tchoe's talk will attempt to evaluate impact of health care policy under a decade of progressive governments in Korea. Although equity in both access to care and financial responsibility appear to be enhanced, there is controversy about whether the policies were cost-effective or improved health, and what will happen as the new government repeals regulations in the health care market. The return of economic crisis also brings renewed urgency to debates of economic and social policy.
Byongho Tchoe is a 2008-09 visiting scholar at Stanford University. After working at the Korea Development Institute from 1983 to 1995, he took up his current post with the Korea Institute for Health and Social Affairs. He has been influential in formulating health and social policy in Korea, having served as an advisor to the minister of health and social welfare and participated in many task forces and committees. In 2007, he was awarded a National Medal in honor of 30 years achievement related to Korea’s National Health Insurance. He has published many articles and books and served as president of the Korean Association of Health Economics and Policy and as vice president of the Korea Association of Social Security. He holds a master’s degree in public policy from Seoul National University and a Ph.D. in economics from the University of Georgia.
Young Kyung Do is the inaugural Postdoctoral Fellow in Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center. He completed his Ph.D. in health policy and administration at the University of North Carolina at Chapel Hill School of Public Health in August 2008. He has also earned M.D. and Master of Public Health degrees from Seoul National University (in 1997 and 2003, respectively). He earned board certification in preventive medicine from the Korean Medical Association in 2004. He received the First Prize Award in the Graduate Student Paper Competition in the Korea Labor and Income Panel Study Conference in 2007. He also is the recipient of the Harry T. Phillips Award for Outstanding Teaching by a Doctoral Student from the UNC Department of Health Policy and Administration in 2007. In May 2008, he was selected as a New Investigator in Global Health by the Global Health Council.
Daniel and Nancy Okimoto Conference Room
Byongho Tchoe
Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055
Byongho Tchoe is a 2008-09 visiting scholar at Stanford University. He began his research career at the KDI (Korea Development Institute) which is a topnotch government think tank in Korea and served from 1983 to 1995. After earning his PhD in economics, he continued his research career at KIHASA (Korea Institute for Health and Social Affairs) from 1995 up to now.
He has always been an influential resource in formulating health and social policy in Korea, and served as an advisor to the minister of health and social welfare in 2000. He participated as a member of many task forces and committees for health and social policy making. He was awarded a National Medal for contributing 30 years achievement of National Health Insurance in 2007.
He was also active in academic society. He published many articles and books. He served as a president of Korean Association of Health Economics and Policy and a vice president of Korea Association of Social Security. He holds a master's degree in public policy from Seoul National University and a PhD in economics from the University of Georgia.
Young Kyung Do
Young Kyung Do is the inaugural Postdoctoral Fellow in the Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center. He completed his Ph.D. in health policy and administration at the University of North Carolina at Chapel Hill School of Public Health in August 2008. He has also earned M.D. and Master of Public Health degrees from Seoul National University (in 1997 and 2003, respectively). He earned board certification in preventive medicine from the Korean Medical Association in 2004. His research interests include population aging and health care, comparative health policy, health and development, quality of care, program evaluation, and quantitative methods in health research.
He received the First Prize Award in the Graduate Student Paper Competition in the Korea Labor and Income Panel Study Conference in 2007. He also is the recipient of the Harry T. Phillips Award for Outstanding Teaching by a Doctoral Student from the UNC Department of Health Policy and Administration in 2007. In May 2008, he was selected as a New Investigator in Global Health by the Global Health Council.
February 2009 Dispatch - Gender Inequality in Earnings in Industrialized East Asia
Since 2005, research teams comprised of participants from across East Asia have been working on a collaborative survey project known as the East Asian Social Survey (EASS).1 The participating research teams include the Chinese General Social Survey (CGSS) from Hong Kong University of Science and Technology and Renmin University in China; Osaka University of Commerce in Japan (JGSS); SungKyunKwan University in Korea (KGSS); and the Taiwan Social Change Survey (TSCS) at the Academia Sinica, Taiwan. The plan of the project is to conduct a survey with different topics for every two years. The first EASS survey, which focused on Family, was conducted in 2006. KGSS had now integrated the data that the four research teams compiled by the end of 2008. This data set is now ready for research use, both by members of the teams and by other interested parties. The topic for the 2008 survey is Globalization and Culture.
During the past two decades, the export-oriented economies of Japan, Korea, and Taiwan experienced strong economic growth and rising income levels. More women entered the labor markets and obtained better-paid jobs. However, in the regions surveyed, men and women often do not equally share in economic prosperity and there still exists a sex gap in earnings. A paper recently co-written by this author and Paula England,2 using the 2006 EASS data, may be the first attempt to explore the size of the sex gap, the factors that explain the gap, and the variations among Japan, Korea, and Taiwan.3
To explain the disparity between the pay of men and women in the survey nations, we used regression analysis to predict the hourly wage from various characteristics, using separate regressions for men and women in each nation. Then we assessed how much human capital factors may contribute to the sex gap in pay. For each factor, there are two estimates of how much it explains, reflecting whether we use male or female slopes, or rates of return. The table below summarizes some of the paper’s preliminary findings. The last row of the table shows that the sex wage gap is highest in Korea, with Japan coming in second place. In Taiwan, women earned about 82 percent of what men earned. For comparison, in the United States in 2003, the comparable wage ratio of female-over-male was 79.4 percent.
What factors might explain the sex gap in earnings? In Japan, the table shows (20 percent for the make slope and 34 percent for the female slope) that education is a key factor—notably, women are less likely to be college graduates. Another key factor is that women are more likely to work in contingent or temporary jobs than in permanent, full-time employment. In the Korea case, the difference between the male or female slopes is small, and 37 percent (male) to 32 percent (female) of the gap is explained, again, by education, as fewer Korean women have completed college than men. In Taiwan, a much lower share (6 percent for men and to 0 percent for women) is explained, mainly due to potential work experience, followed by employment status. In Taiwan, women actually have more education than men, as more women than men have completed college. This education imbalance supports our finding that the sex gap is largest in Korea, where women are less educated than men, and smallest in Taiwan, where the reverse is true.
Human capital factors (education and potential work experiences) seem to explain smaller proportions in the societies with a smaller gap. On the one hand, if we were to attribute all the elements of the gap not explained by mean differences in our supply-side measures to be sex discrimination, this would imply that a higher portion of Taiwan’s (albeit smaller) gap can explained by pay discrimination. On the other hand, women in Japan and Korea are disadvantaged, both in their educational achievements and their opportunities for regular employment. The contingent or part-time jobs that these women do pay less per hour than do the permanent or full-time jobs in which their male counterparts are employed. The EASS survey indicates, thus far, that economic prosperity and advancement in human capital factors may not naturally bring about sex equality in earnings.
Notes
1 More information on the EASS can be found at http://www.eass.info.
2 Chin-fen Chang and Paula England "Gender Inequality in Earnings in Industrialized East Asia," to be presented at the Beijing RC28 Meeting, Renmin University, Beijing, China, May 14-16, 2009.
3 In this paper, we excluded Chinese data because the other three societies are more comparable to one another in terms of their economic development.
Future of ethnic nationalism in Korea
January 2009 Dispatch - Are Global Protest Movements Becoming Regionalized? The Case Study of the 2008 G8 Summit
In activist communities worldwide, globalization has had an enormous impact, both in the composition of activist groups and the content of their messages. At the same time, regional concerns are playing a significant role in the ways protests are organized, managed, and deployed.
Regardless of their location or their target, it is clear that protest campaigns have, on the one hand, become increasingly globalized. The protests that took place during the July 2008 G8 Toyako Summit in Japan offer a case in point. Approximately one hundred transnational activists flew into Sapporo, a city located near the summit site, and joined various civil and protest activities. Over a loudspeaker, they broadcast statements denouncing the summit meeting as “antidemocratic” and “discriminatory against the poor.” These activists were drawn from East, Southeast, and Central Asia, as well as Europe and North America, and they voiced correspondingly global concerns—for human rights, global peace, and democracy, and against inequality and poverty. These themes echoed those of other major global protests, including demonstrations that took place against the International Monetary Fund and the World Trade Organization, the latter most notably in 1999 in Seattle. Indeed, protests of this kind represent what might be called an antiglobalization movement
On the other hand, global movements of this kind also appear to be organized on an increasingly regional basis. Though the activists who protested the Toyako Summit came from all over the world, and addressed topics of global importance, most of the participants came mainly from South Korea, Hong Kong, and Taiwan. Given this apparent dichotomy, the question arises: Will global social movements become regional?
One could argue that global social movements are and will remain regional, at least for the time being, for two practical reasons. First, the costs associated with flight to activist hubs near protest sites can be expensive. Second, the amount of time spent in transition to the protest site becomes a burden. The time doubles when taking into consideration the time spent to return to the originating country. These factors can be prohibitive especially to those based far away, but are less burdensome to regional activists, thus making it easier for nearby protesters to participate.
While time and cost are no doubt a concern, they may not be as important when compared with the other factors. Language is among these factors. Cooperative activities beyond the national borders are on the rise, yet many foreign activists do not speak the languages spoken in the countries where they protest. They invariably rely on English, widely accepted as the “global” language. Yet the levels of English fluency differ among participating activists, and this is a key factor. With their English ability, activists from Europe and North America tend to communicate with others on an individual basis, while those from nearby countries often rely on interpreters, especially when discussions delve into the details of the planned activity and necessary arrangements associated with it. Typically, interpreters are group leaders, well educated and knowledgeable about regional and global issues—and these individuals facilitate most intergroup communication.
Preestablished ties and preexisting communication can influence negotiation and cooperation processes among activists. Global social movements tend to enhance crossnational cooperation among participating activists—that is, activists who come together from different countries often regroup elsewhere, building on their previous cooperative activities. In the case of the 2008 G8 summit protests, regionalization was very much at work. Several months prior to the summit, Japanese media activists planned a temporary umbrella organization called the G8 Media Network, which helped to accommodate incoming foreign media activists and arranged international cooperative activities during the summit. As it happened, the foreign activists and groups that interacted with the G8 Media Network were actually regional, originating mainly from South Korea and Hong Kong. Under the auspices of the G8 Media Network, these groups of activists arrived prior to the summit and stayed until it concluded. Afterward, the same media groups discussed the continuation of crossnational cooperation. Though technically foreign, the dominant actors and groups who sought to continue cooperative activities were, in fact, only from neighboring countries.
Looking more closely at participants in the global protest activities provides further insight into contemporary global protest movements. At the 2008 G8 Summit protests, two different types of foreign participants were on display—those who had prior ties to host activist groups in Japan, and those who did not. The former group could be described as professional activists, whose preestablished ties ensure that they have good knowledge of a given protest’s scheduled activities. The professional group also organizes its own plans of action, precoordinated with domestic groups. The latter group tends to be traveling activists, a more or less independent and unorganized collection of individuals who enjoy traveling the globe and joining the activities offered at protest sites worldwide. The professional activist group is often drawn largely from neighboring countries in the region.
Most global social movements feature participants from around the world. At the same time, signs of regionalization also exist, making most protests both global and regional in nature. One could claim that the future of global social movements is regional. But whether global or regional, it is vital that we continue to study the composition of global protest movements and their abiding impact on civil society.