Universal healthcare systems have undergone a severe stress test in the form of the ongoing COVID-19 pandemic. With respect to the system-embedded allocation of decision-making powers and responsibilities among actors, different modalities have been revealed in the COVID-19 responses of South Korea and the UK, respectively. This article compares and analyzes how these two countries’ healthcare systems have reacted to COVID-19. Although both have implemented similar responsive measures, the UK has recorded a higher number of confirmed cases per thousand people and a higher death rate. Based on the analysis on which this paper is built, the key differences between the two systems are the UK system’s lack of: (1) appropriate medical equipment and technologies along with the human resources; and (2) flexible policy options to incentivize healthcare providers and induce cooperation from the public in a time of national crisis. The UK’s healthcare system is now approaching a critical juncture. The expansion of internal competition, which was introduced to the system in 1991, can serve as means of initiating a resolution to the above-mentioned issues and further reform its system. Under the UK government’s close supervision and precise control, allowing non-reimbursable special medical treatment in the system and widening public choice of medical services would be a suitable policy approach promoting internal competition while at the same time maintaining the UK’s devotion to universal healthcare. The underlying implication of internal competition though is the sharing of decision-making powers and responsibilities with societal and private sectors by inducing and facilitating participation at all levels. Fighting against COVID-19 however is widely considered ‘all-out-war.’ Under the UK government’s supervision and control, it is time for society to step up and fight the pandemic together.

通用医疗系统已经以持续进行的COVID-19大流行的形式经历了严峻的压力测试。关于参与者之间决策权和责任的系统内嵌式分配，分别在韩国和英国的COVID-19答复中揭示了不同的方式。本文比较并分析了这两个国家的医疗保健系统对COVID-19的反应。尽管两者都采取了类似的应对措施，但英国每千人确诊病例数和死亡率更高。根据本文的分析，这两个系统之间的主要区别是英国系统缺乏：（1）合适的医疗设备和技术以及人力资源；（2）灵活的政策选择，以激励医疗保健提供者并在国家危机时期引导公众进行合作。英国的医疗保健系统现在正接近关键时刻。1991年引入内部竞争的制度可以用来启动解决上述问题并进一步改革其制度的手段。在英国政府的密切监督和严格控制下，允许在系统中提供无偿特殊医疗服务，并扩大公共医疗服务选择范围将是促进内部竞争并同时保持英国对全民医疗服务奉献精神的合适政策方法。内部竞争的基本含义是通过诱导和促进各级参与与社会和私营部门分享决策权和责任。但是，与COVID-19的战斗被广泛认为是“全面战争”。在英国政府的监督和控制下，现在是社会加紧对抗流行病的时候了。