Going separate ways? The reform of health insurance funds in Germany, Japan and South Korea

Many aspects of Japanese and Korean national health insurance systems were modelled after the German system of social insurance where non-competitive sickness funds were based on a corporatist principle. Far from converging or remaining on a corporatist path, however, each country has followed a distinctive reform trajectory in an era of globalisation: Germany choosing to grant freedom of choice between different sickness funds, Japan maintaining a multiplicity of insurance societies, and Korea merging all health insurance societies into one. This article examines the reform process underpinning health insurance funds in these three countries where significant similarities as well as differences exist. It then argues that looking into the unique institutional opportunities of the time explains how and why these governments have adopted these paths to achieve dual objectives of cost containment and social solidarity.