This article analyzes the formation of the development-oriented path of the South Korean healthcare system in the 1960s as a complex outcome of shifts in domestic politics and foreign aid. To this end, it focuses on the Public Health Evaluation & Planning Program (1960—1962), a program that coincided with the intersection of political upheavals—the April Revolution and the May 16 military coup—and a transition in U.S. aid policy to Korea.
The April Revolution led to the collapse of the Syngman Rhee regime, which had prioritized defense and development, allowing a welfare state discourse to emerge. Popular aspirations unleashed by the revolution created cracks in the ideological landscape of the 1950s, which had been dominated by the defense-and-development-first policy. From a perspective advocating the harmonization of welfare and the economy, Korean health experts and the USOM Health and Sanitation Division strongly argued for an expanded governmental role in healthcare after the revolution. This effort materialized as the Public Health Evaluation & Planning Program, a common preliminary step for long-term health planning in the international health field at the time.
The military junta, which seized power through the coup a year after the revolution, sealed the cracks created by the revolution. They adopted an explicit development-first policy and focused on economic development, grounded in the logic of subsuming welfare within the framework of economic growth. Concurrently, aiming to reduce the economic burden of aid, the U.S. government rapidly curtailed public health assistance—the material foundation of Korea’s healthcare system. Furthermore, amidst the reorganization of aid agencies, the USOM Health and Sanitation Division—which had emphasized the parallel pursuit of welfare and development—was dismantled. USOM began to promote the establishment of a development-oriented healthcare system in Korea. The Korean healthcare system rapidly achieved ‘self-sufficiency’ from the U.S. but without the intended expansion of the government’s role. This dual shock of the early 1960s—the military coup and the shift in U.S. aid policy—functioned as a critical juncture, locking the Korean healthcare system into the development-oriented path.

This research examines the expansion and characteristics of the Korean Army’s chain of medical evacuation in 1948–1953. The most important goal of the chain of medical evacuation was to conserve fighting strength, which cannot be achieved only by sending the sick and wounded to the rear for treatment. It was more important to maintain as many mission-capable wounded soldiers on the frontline. Therefore, triage for conserving strength was the priority in the evacuation process, and military doctors conducting triage played a significant role. Focusing on military doctors, this article studies the instability of the Korean Army’s medical evacuation chain.
Although Korea was liberated from Japanese colonial rule in August 1945, Korea had no army or army medical services. With the support of KMAG, the Korean Army was able to build a nationwide evacuation chain during the Korean War. However, the expansion of the medical evacuation chain resulted in instability. At the heart of the instability was manpower, rather than organization and transportation. Koreans had almost no experience with the military medical services before 1948, and during the Korean War, most doctors, who had been conscripted after the outbreak of the war, were not trained as military doctors. Therefore, the Korean Army had no other choice but to conduct medical evacuations using mobilized civilian doctors who were not sufficiently trained as military doctors. The escalating war revealed the problems of civilian doctors in military uniforms. Unlike the goal of the chain of medical evacuation, they easily evacuated patients and were reluctant to release patients to return to their duties. Korean Army doctors who were not sufficiently trained as military doctors struggled between the goals of military medical services and those of medical care. Consequently, the military doctors and the instability of the medical evacuation chain during the Korean War reflect the fundamental tension between war and medicine.