A critical juncture in universal healthcare: insights from South Korea’s COVID-19 experience for the United Kingdom to consider

Universal healthcare systems have undergone a severe stress test in the form of the ongoing COVID-19 pandemic. With respect to the system-embedded allocation of decision-making powers and responsibilities among actors, different modalities have been revealed in the COVID-19 responses of South Korea and the UK, respectively. This article compares and analyzes how these two countries’ healthcare systems have reacted to COVID-19. Although both have implemented similar responsive measures, the UK has recorded a higher number of confirmed cases per thousand people and a higher death rate. Based on the analysis on which this paper is built, the key differences between the two systems are the UK system’s lack of: (1) appropriate medical equipment and technologies along with the human resources; and (2) flexible policy options to incentivize healthcare providers and induce cooperation from the public in a time of national crisis. The UK’s healthcare system is now approaching a critical juncture. The expansion of internal competition, which was introduced to the system in 1991, can serve as means of initiating a resolution to the above-mentioned issues and further reform its system. Under the UK government’s close supervision and precise control, allowing non-reimbursable special medical treatment in the system and widening public choice of medical services would be a suitable policy approach promoting internal competition while at the same time maintaining the UK’s devotion to universal healthcare. The underlying implication of internal competition though is the sharing of decision-making powers and responsibilities with societal and private sectors by inducing and facilitating participation at all levels. Fighting against COVID-19 however is widely considered ‘all-out-war.’ Under the UK government’s supervision and control, it is time for society to step up and fight the pandemic together.