Uneven inclusion: consequences of universal healthcare in Thailand

The notion of ‘‘regulatory capture’’ is typically used to describe the takeover of state agencies by outside interest groups that seek to weaken regulation and advance the agendas of interest groups through control over state policy levers. This concept can be contrasted with that of ‘‘developmental capture’’ of state agencies by networks of reformist bureaucrats within the state who seek to promote inclusive state social and developmental policies of benefit to the broader populace. Building on work that has pointed to instances in which state bureaucrats act autonomously from societal and political pressures, this article argues that existing explanations are insufficient for explaining Thailand’s universal health care policy. It points to the critical role played by a network of bureaucrats within the state who strategically mobilized resources in the bureaucracy, political parties, civil society, and international organizations to institutionalize universal health care in the face of broader professional dissent, political uncertainty, and international pressure.

2019

In 2017, the World Health Assembly (WHA) endorsed a resolution, ‘Promoting the Health of Refugees and Migrants’ (WHA 70.15), leading to the development of the ‘Draft Global Action Plan, 2019-2023’ in 2019. These agreements were supported by Thailand and many other countries. During negotiation of such agreements, there were debates and criticisms, particularly on issues of shared responsibility and ownership of countries, clarification of roles among key stakeholders, distinction between illegal and legal migrants, and commitment of member states to implement actions specified in the agreements while maintaining national sovereignty (Table 1).

In the last decades, there have been many major global events that constitute the population shifts and migration. However, not every migration is voluntary; conflicts, natural disasters and worsening economic crises play major roles in the increasing trend of human migrations. These instances not only threaten the lives but also the livelihood of all parties affected. For these reasons, human rights have now become a major topic in the world stage. Human rights violations occur with alarming frequency in many places around the globe and will likely continue to worsen. Stateless people are one of the most complicated instances of migrants. Not only do they lack nationality but also protection afforded to them by the state. This people are one of the most vulnerable and susceptible to the abuse. Due to the complicated nature of their ordeals, oftentimes it is extremely difficult to provide aids and assistance. Furthermore, the lack of resources and the unwillingness of the international community to extend a helping hand aggravate the situation to the scale never before seen. Statelessness in Thailand is not a new issue. Geographically, Thailand is situated at the centre of South East Asia, and, accordingly, is a hub for trades, communication and transportation. Therefore, it is not surprising that the Kingdom also has its fair share of the history and problems regarding the stateless people. This is reflected by its laws and policies, especially those in the past five decades. In this instance, this paper would attempt to define the term "statelessness" as comprehensively as possible. Additionally, the author would like to point out the causes of the problems, the current situations and the developing trends, globally and locally. This paper would also like to provide the sources of the law regarding human rights and stateless persons, both of the international law and of the municipal law. Furthermore, The author would like to provide suggestions and the possible solutions that could, at the very least, give ways to the ideas and inspire people of all ages and races to help and contribute to the cause of saving and helping fellow human beings.

In this chapter, we look at how economic, political, social, cultural and biological influences work together within the space of the Association of Southeast Asian Nations’ (ASEAN) political, economic and social ‘community’ experiment, which today encompasses over 600 million people. We focus specifically on how economic liberalization and the corollary increases in movements of people, goods and services within, between and beyond ASEAN member-states is transforming and challenging entrenched ideas about who is entitled to and responsible for health and social care within and across national borders.

Towards Universal Health Care in Emerging Economies, 2017

The United Nations Research Institute for Social Development (UNRISD) is an autonomous research institute within the UN system that undertakes multidisciplinary research and policy analysis on the social dimensions of contemporary development issues. Through our work we aim to ensure that social equity, inclusion and justice are central to development thinking, policy and practice.

International Journal of Environmental Research and Public Health

Migrants’ access to healthcare has attracted attention from policy makers in Thailand for many years. The most relevant policies have been (i) the Health Insurance Card Scheme (HICS) and (ii) the One Stop Service (OSS) registration measure, targeting undocumented migrants from neighbouring countries. This study sought to examine gaps and dissonance between de jure policy intention and de facto implementation through qualitative methods. In-depth interviews with policy makers and local implementers and document reviews of migrant-related laws and regulations were undertaken. Framework analysis with inductive and deductive coding was undertaken. Ranong province was chosen as the study area as it had the largest proportion of migrants. Though the government required undocumented migrants to buy the insurance card and undertake nationality verification (NV) through the OSS, in reality a large number of migrants were left uninsured and the NV made limited progress. Unclear policy message...

Risk management and healthcare policy, 2017

Of the 65 million residents in Thailand, >1.5 million are undocumented/illegal migrants from neighboring countries. Despite several policies being launched to improve access to care for these migrants, policy implementation has always faced numerous challenges. This study aimed to investigate the policy makers' views on the challenges of implementing policies to protect the health of undocumented/illegal migrants in light of the dynamics of all of the migrant policies in Thailand. This study used a qualitative approach. Data were collected by document review, from related laws/regulations concerning migration policy over the past 40 years, and from in-depth interviews with seven key policy-level officials. Thematic analysis was applied. Three critical themes emerged, namely, national security, economic necessity, and health protection. The national security discourse played a dominant role from the early 1900s up to the 1980s as Thailand attempted to defend itself from the th...

Thailand adopted a new system of spatial administration in 1894 following great transformations of the nineteenth century that saw the consolidation and modernisation of the Thai state. This replaced the emphasis on control of manpower and resource mobilisation under the old patronage system where people were the registered subjects of either lords or kings. Under the new system, people became citizens of Siam, subject to the Thai government under Thai law, free to work and pay taxes to the central government instead of paying tax in kind and being conscripted to their own lord (Pongsawat, 2007:111). The Thai national subject was thereby brought into being: commoners and slaves were freed from the local landlords to become subjects of the centralised government, eligible for all political, social, and economic rights guaranteed by the constitution, including labour and social welfare regulations. During the twentieth century this entitlement has been distributed to those in possession of a Thai National Identity Card. Those excluded from such entitlement include “illegal” immigrants or “illegal” aliens. While states customarily exercise the right to restrict the mobility of non-nationals across and within their borders, this paper looks at the political-economic logic behind the treatment of migrant workers from Myanmar under the temporary work permit scheme. Given common practices - such as employers' retention of official documentation, the ensuing restrictions on their mobility, vulnerability to extortion from state officials and exploitation from employers, and the restricted access to labour and social welfare regulations to which Thai citizens are entitled - the paper raises the question of whether, in the case of marginalised populations, this amounts to a de facto perpetuation of the old patronage system of bonded labour and exploitation. If so, it explores the prospect of Thailand fully superseding this condition or whether such neo-feudal practices are inexorably entwined with Thailand's political economy.