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

Published online by Cambridge University Press:  14 July 2022

Tauchid Komara Yuda Open the ORCID record for Tauchid Komara Yuda [Opens in a new window]  and
Aungsumalee Pholpark
Tauchid Komara Yuda
Affiliation:
Department of Social Development and Welfare, Universitas Gadjah Mada, Yogyakarta, Indonesia Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong
Aungsumalee Pholpark*
Affiliation:
Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
*
Email: aungsumalee.pho@mahidol.ac.th
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Abstract

This article provides an overview of the scholarship on healthcare reform in democratic middle-income countries through comparative cases from Indonesia and Thailand. This study identifies the reasons why Thailand has achieved universal healthcare faster than Indonesia and analyses the policy outputs towards universalism resulting from unfolding reforms. Taking a closer look at the causal mechanisms underpinning healthcare developments (clientelistic-based mechanism and limited vertical alliance-based mechanism), we discuss how changes in political economy have enhanced the state’s intervention in the healthcare sector while reproducing the fragmented and stratified nature of the system. Based on coverage, generosity and financial risk protection, Thailand has a higher degree of universalism in comparison with Indonesia. The article suggests that the welfare regime now governing healthcare can be conceptualised as a developmental-universalist state, while noting a less-effective model for Indonesia and a more effective model for Thailand.

Keywords

Democratic middle-income countrieshealthcare reformwelfare regimesSoutheast AsiaIndonesiaThailand
Type
Research Article
Information
Journal of International and Comparative Social Policy , Volume 38 , Issue 2 , July 2022 , pp. 111 - 129
Copyright
© The Author(s), 2022. Published by Cambridge University Press in association with Social Policy Association

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