Exchange: Explaining the Passage of Universal Healthcare in Thailand

Abstract

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.

Diffusion of global health norms through a national medical professional movement in the universal healthcare of Thailand

“…Furthermore, global health idea transfer can occur to a greater extent from IOs to national states vertically and from national states to national states horizontally. Most literature on Thailand’s health system reform often focuses on national processes in the first place ( 7 , 10 , 64 – 66 ). In practice, achieving equity in health at a national level could not be possible without transnational or global health idea transfer, and in reverse, national best practices can inspire global actors to adopt national ideas into their policy papers, such as the national universal health coverage achievement in Thailand.…”

Healthcare expansion in Indonesia and Thailand: a causal mechanism and its implications for welfare regimes

“…Dr. Mongkol Na Songkhla, Permanent Secretary of MOPH, the highest-ranking civil service official, who had close links with the network rural doctors, committed to the rapid implementation of the UCS policy and expected to enact this program before his retirement due to the uncertainty of political commitment and stability (Harris, 2017). With the strong leadership of Permanent Secretary and progressive executives of the MOPH, starting in April 2001, the UCS policy has been rapidly implemented through a pilot project that expanded nationally within 1 year even before the legislation of the National Security Act in November 2002 (Harris, 2015; Harris & Selway, 2020).…”

Roundtable on Teri L. Caraway's “De-Thaksinizing Thailand: The Limits of Institutional Design” – Joel Sawat Selway

“…Small parties were less able to compete. TRT brought professionals into the party to develop independent policy expertise (Harris and Selway 2020). They consulted ministries over pilot programs that they could bring into their party manifestos (Harris 2015).…”