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This article examines changing politics and its impacts on the interest conflict between policy actors and the policy-making dynamism in the process of health care reform in the 1980s Korea. A special focus is brought onto analysing the struggle for integrating health insurers, in order to examine the dynamic relations between politics, interest conflict and policy-making during the years of political turbulence. In detail, this article tries to answer the following research questions: in what ways had Korea’s political context and institutions changed in the 1980s and in what ways had these changes influenced the dynamics of interest conflict and policy-making of pursuing the merger of health insurers? To answer these research questions, this article compares the two case studies on the ensuing debates of the 1980s to establish a single health insurer system.