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Exchange: Explaining the Passage of Universal Healthcare in Thailand
Joseph Harris,Joel Sawat Selway 동아시아연구원 2020 Journal of East Asian Studies Vol.20 No.1
What explains the passage of Thailand's landmark universal healthcare (UHC) policy? In separate contributions, Selway and Harris emphasized the role of electoral rules and political parties, on one hand, and “professional movements” of developmentally minded state bureaucrats on the other. Which is correct? In this article, Selway and Harris respond to each other's work. While Selway agrees that the actions of the professional movement constitute an underappreciated necessary condition for universal healthcare in Thailand, he argues that Harris overstates the role of the movement in implementation. Harris defends his position and maintains that an institution-focused account is insufficient, arguing that the actions of Thailand's Rural Doctors’ Movement not only explain universal healthcare but also gave rise to the very electoral rule changes that Selway argues were so critical to facilitating universal coverage. Selway responds to these criticisms, and the two researchers jointly consider implications for causation, qualitative research, and policymaking theory.
Allen Hicken,Joel Sawat Selway 동아시아연구원 2012 Journal of East Asian Studies Vol.12 No.1
In 2007, those behind the 2006 coup drafted a new constitution specifically aimed at turning back the political and policymaking clock to the pre-1997 era. However, in the preceding decade a significant transformation of Thai politics had taken place. Specifically, social cleavages had become politicized and particized in ways we have not seen before, and policy-focused, popular party programs had become part and parcel of serious party campaign strategies. Focusing on health policy, we thus argue in this article that institutional reforms have had predictable and observable implications for policymaking in Thailand, but only when considered in the context of changes to the broader social structure and other political conditions. While the 1997 reforms brought about a well-documented shift toward a more centralized, coordinated, and nationally focused policymaking environment, the 2007 reforms have been less successful at reversing that impact. In short, the coup makers are finding it harder than they supposed to force the genie back into the bottle.