Public Preferences for a Unified Healthcare System in Korea: Generational and Ideological Insights

Background/Objectives: In the context of potential Korean unification, integrating South Korea’s robust but strained healthcare system with North Korea’s resource-deficient framework presents significant challenges. This study explores public preferences for a unified healthcare system, focusing on generational and ideological factors. Methods A total of 800 adults aged 19–59 were recruited using proportional quota sampling. Preferences for a unified healthcare system, perceptions of unification necessity, and expected personal benefits were analyzed using logistic regression, adjusting for age, gender, education level, subjective social status, and political ideology. Results This study examines age and political orientation in relation to healthcare preferences and perceptions of Korean reunification. Right-wing individuals in their 20s and 30s (OR: 2.41) and 40s and 50s (OR: 2.21) are more likely to favor maintaining the current healthcare system compared to non-political individuals in their 40s and 50s. Support for reunification is lower among 20s and 30s, especially right-wing (OR: 0.36) and non-political (OR: 0.46) groups, while left-wing individuals in their 40s and 50s (OR: 2.07) show stronger support. Perceived personal benefits from reunification are highest among left-wing individuals in their 20s and 30s (OR: 4.60) and 40s and 50s (OR: 2.97). These findings highlight the influence of demographic and political factors on key social attitudes. Conclusions Public preferences for a unified healthcare system are influenced by both pragmatic and ideological considerations. To ensure sustainable integration, healthcare policies must address generational and political divides while prioritizing equitable access and social cohesion in a unified Korea.