Although policy priority has always been on economic management in East Asian countries, those countries also developed some notable social policies. However, explanations for the development of social policies in those countries have been relatively underdeveloped compared to those of their economic management policies. This study adds to our understanding of the social policy development in East Asia by examining two cases of social policy adoption in South Korea – the Medical Insurance Law and the Minimum Wage Law. This Korean case study shows a pattern of policy development primarily driven by particular ‘interests’ (state elites' perceived political survival needs and their reputation in international society), with ‘environmental’ factors and ‘policy legacies’ playing a supplementary role. In particular, these policies are interpreted as anticipatory concessions to moderate members of Korean society by the state elites who aimed to stabilise their regimes by separating radicals from moderates. In addition, the medical insurance scheme is understood as a by-product of the competition between the South and North Korean regimes. This study also draws our attention to such issues as the similarities and differences between the East Asian welfare regimes and the change and continuity in the development of social policies in East Asia.