Obstacles to regulating the private sector: The case of Korean long-term care

This paper examines the attempts to improve public accountability in the private-led Korean Long-Term Care (LTC) insurance system, illustrating their characteristics and limitations. Korea introduced universal LTC insurance in 2008, but with the purposeful exclusion of public provision, for-profit providers were able to take part without regulation, which caused problems such as low-quality services and widespread corruption. In response, the government tried to improve public accountability through various regulations such as new accounting/finance rules, but when such regulations had negative effects on their profits, they were met with stout resistance from providers. This case study of Korean LTC insurance illustrates the difficulty of implementing regulations to improve public accountability in a private welfare system.