BACKGROUND: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. METHODS: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. RESULTS: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. CONCLUSION: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.
Consumer Participation ; Decision Making ; Delivery of Health Care ; Democracy ; Insurance, Health ; Learning ; Negotiating ; Policy Making ; Social Responsibility

Republic of Korea has experienced rapid economic growth over the last several decades. During this period, some medical schools have been founded with inadequate educational resources. Currently, the Korean medical faculties are frustrated due to the sense of inability to improve the quality of education provided by troubled medical schools. In fact, this phenomenon is a consequence of the reckless establishment of new medical schools. Unfortunately, the Ministry of Education, which claims to reserve the right to grant permission to establish new medical schools, cannot manage this situation either. The Ministry is very reluctant to endorse disciplinary measures based on the standards set by the accreditation agency; instead, it insists on using the court system. In East Asia, there is no history of self-regulation, and very often, the power of the government far exceeds that of professional organizations. This can create tension between an accreditation agency and the government. Even though the Korean Ministry of Education has created a new system recognizing the authority of the accreditation agency, it has not taken into account the specialized aspects of medical education. The government has also stated that only the law can mediate the regulation of low-quality education, so the standards set by the accrediting agency are not legally binding. Despite the good quality-control system that has been put in place for the last 13 years by the Korean Institute of Medical Education and Evaluation the Ministry wants to have authority over any corrective measures. Republic of Korea may have achieved democracy at the macro-level, but this is a time when democracy should be implemented with regard to a specific constituency and an important issue.
Accreditation* ; Democracy ; Economic Development ; Education ; Education, Medical* ; Faculty, Medical ; Far East ; Financing, Organized ; Humans ; Jurisprudence ; Republic of Korea* ; Schools, Medical ; Societies

In this article, I looked at the life of Yun Il-sun, a representative medical scientist of modern Korea, and examined the following problems. First, I took note of the position of the Korean people in the academic system of the Japanese colonial empire and restored the life of Yun Il-sun as specifically as possible. Yun was educated among Japanese people from elementary school to university. Although he received the best education at Old System High School and Imperial University and grew to be a prominent medical scientist, he could not overcome his identity as a colonized. Yun Il-sun, who moved from Keijo Imperial University to Severance Union Medical College, involved in activities founding of the Korean Medical Association and the Korean Medical Journal. Second, I the meaning of ‘culture’ to the intellectuals in the periphery. Old System High School and Imperial University where Yun Il-sun was educated were the hotbed of ‘culturalism.’ Yun's college days were the heyday of Taisho Democracy, and students were attracted to Marxism, Christian poverty movement, Buddhist cultivation movement and so on. Yun sought to overcome the ideological of young people through the acquisition of ‘culture.’ The ‘culture’ emphasized by Yun had an enlightenment characteristic that emphasized education, but it also functioned as a‘identity culture of educated elites.’ Third, I used the concept of ‘colonial academism’ and examined the aspects and characteristics of the colonial-periphery academic field, focusing on medicine. Yun Il-sun was a Korean professor at the Keijo Imperial University. He founded an academic society and published an academic journal for Koreans. He attempted to reproduce scholarship by doctoral dissertations. At the same time, several facts show that he was also in the affected area of ‘colonial academism’: the fact that he was kicked out of the Keijo Imperial University, the fact that the Korean Medical Association and the Korean Medical Journal were banned by Governor General, the fact that his students asked for doctoral degrees from Kyoto Imperial University where he studied. Yun Il-sun crossed the limits of ‘colonial academism’ and acted as the agent of empire. This was made possible by the characteristics of the academic discipline of medicine, the environment of the Severance Union Medical College, and personal traits of superior ability and indifference to politics. I the postcolonial evolution of the ‘colonial academism’ and ‘culturalism.’ The mix of continuity and discontinuity from ‘colonial academism’ and the hybrid of Japanese academism and American academism, the Korean characteristics of ‘postcolonial academism.’ Yun tried to harmonize the American academism with the Japanese academism and the purity of academism. This effort was revealed as an emphasis on basic medicine and natural sciences. As combined with culturalism and indifference to politics, he was recognized as the symbol of ivory tower and academism.
Asian Continental Ancestry Group ; Colon ; Communism ; Democracy ; Education ; Fellowships and Scholarships ; Humans ; Japan* ; Korea ; Natural Science Disciplines ; Pathology ; Politics ; Poverty