Social Policy in a Development Context

Social Policy in a Development Context Aims of the Series Social Policy in a Development Context is a series which places social policy at the centre of research while maintaining UNRISD's unified approach to social development. The series provides a new and exciting contribution to the literature in economic development and social policy. In economic development, social policy has been recognized as an inte- gral part of development, but the literature often falls short of elaborating social policy for a unified approach to economic and social development. In social policy, analysis has concentrated mainly on European and North American countries, and studies on developing countries often lack comparative rigour. The bridge between economic development and social policy will not only contribute to the academic research but also inform the policy debate at the international and national levels.

More information about this series at http://www.springer.com/mycopy/series/[14480] Ilcheong Yi Editor Towards Universal Health Care in Emerging Economies

Opportunities and Challenges Editor Ilcheong Yi Senior Research Coordinator, UNRISD Geneva, Switzerland

ISBN 978-1-137-53376-0 ISBN 978-1-137-53377-7 (eBook) DOI 10.1057/978-1-137-53377-7

Library of Congress Control Number: 2016963611

© United Nations Research Institute for Social Development 2017 The author(s) has/have asserted their right(s) to be identified as the author(s) of this work in accordance with the Copyright, Designs and Patents Act 1988. This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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This Palgrave Macmillan imprint is published by Springer Nature The registered company is Macmillan Publishers Ltd. The registered company address is: The Campus, 4 Crinan Street, London, N1 9XW, United Kingdom Foreword

Whether social services and protection are available to all people, or governments choose to take a more targeted approach to social policy, has been one of the most vibrant development debates over the past three decades. The United Nations Research Institute for Social Development (UNRISD) has long been on the front line of the struggle for more inclusive and sustainable development, promoting not only universal approaches but also the concept of transformative social policy—that is, state intervention that, in addition to providing social protection, directly affects redistribution, production and reproduction. An autonomous research institute within the United Nations system, UNRISD provides critical analysis and evidence on the political forces and institutional drivers that shape social policy. UNRISD has paid particular attention to the comparative effectiveness of universal and targeted social policy and programmes, and how they help to reduce poverty and inequality in developing countries. This has led us to critique targeted approaches in social service provision based on evidence that, compared with universal approaches, targeting and selectivity are less cost-effective and sustainable, and are more likely to infringe human rights and weaken social solidarity. UNRISD research highlights the importance of universal social policy as both a means and an ends: a way of tackling persistent poverty and growing inequalities, and of reaffirming the values and goals of universality set forth in international agreements from the Universal v vi Foreword

Declaration of Human Rights to the Millennium Development Goals and, most recently, the 2030 Agenda for Sustainable Development which also calls for the transformation of our world and for no one to be left behind. Universalism in social service provision is defined and redefined by interactions between diverse political forces and through policy processes at different levels of governance. Although recent international agreements, notably the 2030 Agenda, have swung the pendulum back towards universal social service provision, national-level forces (such as the imposition of austerity measures in many countries) strongly shape the definition, parameters and practice of universalism in social policy. Research that is both strategic and practical, moving beyond polemical debates to concrete evidence-based recommendations, can help countries identify the institutions, actors and processes conducive to more inclusive and sustainable forms of universal social service provision. When designing this research project with partners, UNRISD selected eight countries at different stages of universalization in their health sec- tors. These countries, characterized as ‘emerging economies’, attract academic and policy interest due to their economic performance regionally and globally. While academic research on their economic dynamics is abundant, research on how they have designed and implemented social policies, and how the latter interact with economic policies and political change, is relatively scarce. This book helps improve understanding of the dimensions, policy linkages and drivers of universalization of health care, and, through the study of countries along a broad spectrum of universalization in their health care systems, demonstrates that there are diverse pathways towards universalism in health care. Although it is almost impossible, and certainly not desirable, to dis- til general lessons that fit all socio-economic and political contexts from these case studies, there are still some common points that are indicative of strategies to achieve more inclusive and sustainable universal social policy. These include the necessity of creating mutually reinforcing mechanisms between social movements and governments as a new form of politics of welfare expansion; the importance of continuously advocat- ing for and strengthening universality; and the imperative to engage and Foreword vii incentivize the private sector to work in the public interest. These all pose both challenges and opportunities to policy stakeholders involved in health governance, which itself is a sphere of negotiation, compro- mise and consensus building around fundamental values, key policies and political coalitions. Learning lessons from any developmental experience is not an easy task. The first step is to recognize that institutions and policies are context-specific. We expect this book and its case studies to inspire readers and policy makers in developing countries to cast off ‘one-size-fits-all’ recommendations, and to establish their own specific strategies, institutions and policies for universalization. UNRISD would like to take this opportunity to thank the Hospital do Coração (HCor) and the Ministry of Health of the Federative Republic of Brazil (through the Institutional Development Program of the Unified Health System/PROADI SUS) for generous financial support for this project. The research project was conceived in partnership with the World Social Forum on Health and Social Security and the Public Health Movement in Brazil, and was inspired by the 1st World Conference on the Development of Universal Social Security Systems held in Brasilia in 2010. Armando de Negri Filho’s knowledge and experience of the World Social Forum on Health and Social Security, Brazil’s Public Health Movement, the Innovations Laboratory at HCor, and a diverse range of universalization processes across the world were instrumental in the design and implementation of the project. Ilcheong Yi and Kelly Stetter (UNRISD), Olive Cocoman (now at the World Health Organization) and Elizabeth Koechlein (now at AcademyHealth) made tremendous contributions to this project and resulting book, with their roles ranging from project design and coordination to writing and editing. Elena Camilletti, Benedict Craven, Anna Dadswell, Rewa El Oubari, Louis Vargas Falbaum, Subhash Ghimire, Susanne Gjonnes, Roosa Jolkkonen, Sarah Parker, Claire Peterson, Giulia Scaroni, Saskia Sickinger, Portia Spinks, Emilia Toczydlowska and Barbara Walter, all formerly of UNRISD, provided research and other assistance at various stages. Professor Krishna D. Rao, Department of International Health, Johns Hopkins University, reviewed the entire manuscript and his valuable comments improved the quality of this book. UNRISD viii Foreword appreciates the contributions and support of many other people who cannot be named here, particularly anonymous chapter reviewers. UNRISD also gratefully acknowledges financial support from the Swedish International Development Cooperation Agency, the Swiss Agency for Development and Cooperation and the government of Finland, without which this project would not have been possible.

Paul Ladd Director, UNRISD Contents

1 Introduction: The Universalization of Health Care in Emerging Economies 1 Ilcheong Yi, Elizabeth Koechlein and Armando de Negri Filho

Part I Analyzing Common Pressures and Diverse Social Policy Responses 27

2 The Continuing Enigmas of Social Policy 29 Ben Fine

3 Universalism and Health: The Battle of Ideas 61 Susanne MacGregor

Part II Moving Towards Universal Health Care: Opportunities and Challenges 89

4 The Politics of Health Care Reform in Thailand 91 Erik Martinez Kuhonta

ix x Contents

5 The Impacts of Universalization: A Case Study on Thailand’s Social Protection and Universal Health Coverage 119 Prapaporn Tivayanond Mongkhonvanit and Piya Hanvoravongchai

6 Political and Institutional Drivers of Social Security Universalization in Brazil 155 Marcus André Melo

7 Universalizing Health Care in Brazil: Opportunities and Challenges 181 Ana Luiza d’Ávila Viana, Hudson Pacífico da Silva and Ilcheong Yi

8 What Kind of Welfare State Is Emerging in China? 213 Stein Ringen and Kinglun Ngok

9 China’s Universal Health Care Coverage 239 William Hsiao, Mingqiang Li and Shufang Zhang

Part III Obstacles to Moving Towards Universal Health Care 267

10 Constraints on Universal Health Care in the Russian Federation: Inequality, Informality and the Failures of Mandatory Health Insurance Reforms 269 Linda J. Cook

11 The Fragmented Social Protection System in India: Five Key Rights but Two Missing 297 Santosh Mehrotra, Neha Kumra and Ankita Gandhi Contents xi

12 The Drivers of Universal Health Care in South Africa: The Role of Ideas, Actors and Institutions 321 Rebecca Surender

13 Social Policy in Venezuela: Bucking Neoliberalism or Unsustainable Clientelism? 347 Julia Buxton

14 Expanding Social Security in Indonesia: The Current Processes and Challenges 373 Asep Suryahadi, Vita Febriany and Athia Yumna

Index 405 Notes on Contributors

Julia Buxton is a specialist on politics, security and development in Latin America, focusing in particular on Venezuela. Julia is the author of a number of works, including The Failure of Political Reform in Venezuela (2001); “Venezuela’s Contemporary Political Crisis in Historical Context”, Bulletin of Latin American Research (2005); Venezuela’s Bolivarian Democracy: Participation, Politics, and Culture Under Chavez (co-edited with D. Hellinger and D. Squire 2011); “Venezuela's Bolivarian Revolution”, in G. Lievesley and S. Ludlam, Reclaiming Latin America: Experiments in Radical Social Democracy (2009); and “Swimming Against the Tide: Venezuela and Peace Operations”, in K. Kenkel, South America and Peace Operations: Coming of Age (2011). Linda J. Cook received her PhD from Columbia University in 1985. She is Professor of Political Science and Slavic Studies at Brown University, Associate of the Davis Center for Russian and Eurasian Studies at Harvard University and a member of the International Advisory Board, Center of Excellence, Aleksanteri Institute for Russian and East European Studies, University of Helsinki, Finland. Linda has published The Soviet Social Contract and Why it Failed: Welfare Policy and Workers’ Politics from Brezhnev to Yeltsin (1993), Postcommunist Welfare States: Reform Politics in Russia and Eastern Europe (2007) and numer- ous other publications. Her research interests include the politics of the Russian Federation, East-Central Europe and Eurasia, the domestic and international politics of welfare states, and electoral-authoritarian regimes. Linda is the recip- ient of a Fulbright Scholarship for 2015–17, to complete research on her cur-

xiii xiv Notes on Contributors rent book project, “Political Economies of Health Care in Russia’s Fragmented Welfare State.” Vita Febriany is a PhD candidate at the Amsterdam Institute for Social Science Research (AISSR), Amsterdam University, the Netherlands. Before she began her current studies, she was a senior researcher at the SMERU Research Institute in Jakarta, Indonesia (2010–14). She holds a Master’s degree in Public Policy from the Australian National University. Her main research interest is in the area of social protection issues in Indonesia. In 2011, she and other researchers at SMERU and the Overseas Development Institute (ODI) conducted a study entitled “Politics of Gender and Social Protection in Indonesia.” Previously, she and other SMERU researchers conducted a study on qualitative impact evaluation on conditional cash transfers in Indonesia. She is a member of the Global Research Network for Social Protection in East Asia, which is organized by the Seoul National University in South Korea. Armando de Negri Filho has been a member of the Peoples Health Movement (PHM) since 2003 and is the Executive Committee Coordinator of the World Social Forum on Health and Social Security, former General Coordinator of the Latin American Association of Social Medicine (ALAMES) and former President of the International Society for Equity on Health (ISEqH). As the coordinator of the programmes LIGRESS and PRORADI SUS at the Hospital do Coração, São Paulo, Brazil, he has extensively researched and dealt with projects for the institutional development of the Brazilian National Health System. In the last 12 years, de Negri Filho has advised several social movements and progressive local and national governments of Latin America and is currently involved in the team “Health for All” of the Sustainable Development Solutions Network. He holds an MSc in Epidemiology and and PhD from the Department of Preventive Medicine at the University of São Paulo Medical School. Ben Fine is Professor of Economics at the School of Oriental and African Studies, University of London, and holds honorary positions at the Universities of Johannesburg (Senior Research Fellow attached to the South African Research Chair in Social Change), Rhodes (Visiting Professor, Institute of Social and Economic Research) and University of the Witswatersrand (Associate Researcher, Corporate Strategy and Industrial Development). Ankita Gandhi is an economist by training holding a Master’s degree in Economics from the Delhi School of Economics and is currently pursuing Notes on Contributors xv a doctoral degree from Jawaharlal Nehru University. She works on issues con- cerning human development, labour economics and skill development. She has previously worked with the United Nations Development Programme (UNDP) and the Planning Commission, Government of India. Piya Hanvoravongchai teaches at the Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University. He is an assistant director of the Thailand Research Center for Health Services System at Chulalongkorn University. He is also a co-director of the Equity Initiative, a regional effort to promote transformational leadership for health equity in Asia. He has consulted for many international organizations, including the World Bank, the World Health Organization, Global Health Workforce Alliance and Gesellschaft für Internationale Zusammenarbeit (GIZ). He sits on several policy and governing committees under the Ministry of Public Health and other national health financing schemes. He has published many articles in peer- reviewed journals and has co-authored reports and book chapters on health financing reform, universal health coverage and the community health workforce, and is a member of the editorial board of the Human Resource for Health journal and the Journal of Health Sciences (Thailand). William Hsiao is the K.T. Li Research Professor of Economics at Harvard University. He has developed the analytical models to diagnose the causes for the successes or failures of national health systems. He advised many nations in reforming their national health systems and establishing universal social health insurance, including the United States, China, Taiwan, Sweden, Colombia, Poland, Vietnam, Malaysia, South Africa and Uganda. Taiwan awarded him a Presidential Medal for his design of Taiwan’s successful national health insurance. He was elected to the US National Academy of Medicine and US National Academy of Social Insurance. He is also a fully qualified actuary and has published more than 200 papers and several books. Elizabeth Koechlein is a Research Associate at AcademyHealth, and is respon- sible for outreach, maintenance, and marketing for HSRProj, an online health services research database funded by the National Library of Medicine (USA). Before joining AcademyHealth in April 2015, she worked as a Research Analyst at the United Nations Research Institute for Social Development (UNRISD). Prior to joining UNRISD, she worked at the Rutgers University School of Social Work. She holds a Master of Public Policy from the Edward J. Bloustein School of Urban Planning and Public Policy at Rutgers University. xvi Notes on Contributors

Erik Martinez Kuhonta is Associate Professor in the Department of Political Science at McGill University. He is the author of The Institutional Imperative: The Politics of Equitable Development in Southeast Asia (2011), which was short- listed for the Canadian Political Science Association Prize in Comparative Politics. He is the co-editor of Party System Institutionalization in Asia: Democracies, Autocracies, and the Shadows of the Past (2015) and Southeast Asia in Political Science: Theory, Region, and Qualitative Analysis (2008). He has published articles in a range of journals, including Pacific Affairs, Contemporary Southeast Asia, Comparative Political Studies, Asian Survey and Pacific Review. He received his PhD from Princeton University and has held visiting fellowships at Stanford University, the National University of Singapore, the East–West Center and Kyoto University. Neha Kumra is Assistant Director with the National Institute for Labour Economics Research and Development (India) (earlier called the Institute of Applied Manpower Research). She is working on issues relating to human development, vocational education and training and skills. She holds an MSc in Economics for Development from the University of Oxford and a Postgraduate Diploma in Public Management from the University of London. Mingqiang Li is a post-doctoral fellow in health economics at the T.H. Chan School of Public Health at Harvard University. He received his PhD in 2016 from the Health Systems program at the Harvard School of Public Health.. His doctoral thesis focused on the institutions that facilitate a trust relationship between patients and doctors. He received his Master of Economics from Peking University. In addition to his thesis research, his research interests include the comparative study of health systems between countries, theories and evidence of the governance of medical care delivery and political economy of the health reforms in China. He works closely with Professor William Hsiao as a research fellow of the Program in Health Financing at the Harvard School of Public Health. Susanne MacGregor is Honorary Professor of Social Policy at the London School of Hygiene and Tropical Medicine, attached to the Centre for History in Public Health, and Professor Emerita at Middlesex University London. She is a Fellow of the Academy of Social Sciences and of the Royal Society of Arts. She has an MA in Social Anthropology and a PhD in Politics from the University of Edinburgh and was previously Professor of Social Policy at Goldsmiths, University of London and Reader in Sociology and Social Policy at Birkbeck, University of London. Santosh Mehrotra is Professor of Economics, Centre for Labour and Informal Sector Studies, Jawaharlal Nehru University, New Delhi. He was Director-General, Notes on Contributors xvii

National Institute for Labour Economics Research and Development (India) (earlier called the Institute of Applied Manpower Research), Planning Commission (in the rank of Secretary, Government of India) until August 2014. He holds an MA in Economics from the New School for Social Research, New School University, New York (1981) and a PhD in Economics from the University of Cambridge (1985). He was Associate Professor of Economics, Jawaharlal Nehru University (New Delhi) from 1988 to 1991. From 1991 to 2006, he spent 15 years with two UN agencies, UNICEF and UNDP, in New York. He returned to India in September 2006 to head the Rural Development Division, and then led the Development Policy Division, Planning Commission until August 2009. He has co-authored several chapters in India’s 11th and 12th Five Year Plans and serves as team leader for the second national Human Development Report (Oxford 2011). From 2010–13, he held a three-year appointment as Parkin Visiting Professor at the Centre for International Development in the Faculty of Social Sciences, University of Bath (UK). Marcus André Melo holds a PhD from the University of Sussex and was a Fulbright post-doctoral fellow at Massachusetts Institute of Technology. He was Coca-Cola Company Visiting Professor at Yale University and a former residen- tial fellow at the Rockefeller Foundation. He is also a Fellow of the John Simon Guggenheim Foundation and a Professor of Political Science at the Federal University of Pernambuco. He has co-authored Making Brazil Work: Checking the President in a Multiparty System (2013), Against the Odds: Politicians, Institutions and the Struggle Against Poverty (2012) and Brazil in Transition: Beliefs, Leadership and Institutional Change (2016). He is the author of articles appearing in journals such as Comparative Political Studies, Latin American Research Review, International Political Science Review and The Journal of Democracy, among many others. He has done consulting work for the World Bank, UNDP, UNRISD, the Inter-American Development Bank, the Department for International Development (UK) and GIZ. Prapaporn Tivayanond Mongkhonvanit is the founding director of the Social Policy and Development Programme at Thammasat University. She has been a consultant at a number of international organizations, including the United Nations Children’s Fund (UNICEF) Regional Office for East Asia and the Pacific and the Association of Southeast Asian Nations (ASEAN). She lectures and supervises research in areas of developmental welfare and social protection in Asia, social problems and social changes, and social entrepreneurship. She has written on the role of social protection in managing disaster risk and climate change adaptation in East Asia and the Pacific. She also has broad experience with Fair Trade companies and the One Tambon One Product policy of Thailand. She holds a doctorate degree in Social Policy from Oxford University and an MA xviii Notes on Contributors and BA in Public Policy, Economic History, and International Relations from Victoria University of Wellington, New Zealand. Kinglun Ngok is Professor and Director of the Institute for Social Policy, Center for Chinese Public Administration Research, School of Government at Sun Yat- sen University. His research interests include labour policy, social policy and social security, and social services in China. He has published papers in a number of journals, including Social Policy and Administration, Social Policy and Society, International Review of Administrative Sciences, Problem of Post-Communism , Australia Journal of Public Administration, Asian Survey, Economic and Industrial Democracy, Journal of Poverty and Social Justice. He also serves as the editor of the Chinese Public Policy Review. His most recent book is China’s Social Policy: Transformation and Challenge (co-authored with Chak Kwan Chan, 2016). Stein Ringen is Emeritus Professor of Sociology and Social Policy at the University of Oxford. His books include The Possibility of Politics (1987 and 2006), Citizens, Families and Reform (1997 and 2006), What Democracy Is For (2007), The Korean State and Social Policy (co-authored, 2011), Nation of Devils: Democratic Leadership and the Problem of Obedience (2013) and The Perfect Dictatorship: China in the 21st Century (2016). Hudson Pacífico da Silva is a Visiting Scholar at the Health Research Institute of University of Montreal (Canada), where he develops research activities in the field of health innovations. He earned a Doctorate in Sciences (University of São Paulo, Brazil) with the dissertation “Health Care Dimensions in Brazil: Social Protection and Technical Innovation.” He has a BA in Economics and a Master’s degree in Social Economics, both from the Institute of Economics of University of Campinas, Brazil. Between 2009 and 2010, he was a postdoctoral fellow at the Department of Health Administration, University of Montreal, under the supervision of Dr Pascale Lehoux. In addition to teaching and research, he has professional experience as a technical advisor in the public sector, such as the Brazilian Ministry of Health (2011–12) and the State Government of São Paulo (2007). His teaching and research interests cover the following topics: public policy analysis, social protection, health policy and management and health innovations. Rebecca Surender is a researcher and teacher, specializing in the areas of social policy, with an emphasis on policy in developing countries. Her main focus is on South African social policy, in particular the politics, implementation and Notes on Contributors xix

outcomes of health and income maintenance policies. She is currently a Visiting Professor at Rhodes University, South Africa. Other recent work involves ‘BRICS’ countries (in particular, China and India) as well as a focus on the ‘BRICS’ entity itself. Rebecca was a co-founder and Director of the Centre for the Analysis of South African Social Policy (CASASP) at Oxford University, the first UK academic centre to undertake research exclusively on South African social policy. In addition to her academic roles, she has worked as a consultant and advisor for various multilateral and government agencies and departments, including the World Bank, the Department for International Development (UK) and DSD in South Africa. She has also held several management and leadership positions at Oxford and is a Pro-Vice Chancellor (for Diversity) at the University. Asep Suryahadi is the Director of the SMERU Research Institute in Jakarta, Indonesia. He holds a PhD in Economics from the Australian National University. His research interests cover the areas of poverty, social protection, labor, education, health and economic development in general. His current research topics include the impact of rural–urban migration on social welfare, the impact of child labour on human capital growth and the relationship between inequality and district’s performance on targeting the poor. His latest publications include: “Coping with the Economic Consequences of Ill Health in Indonesia”, Health Economics; “Social Health Insurance for the Poor: Targeting and Impact of Indonesia’s Askeskin Programme”, Social Science & Medicine, and “Sectoral Growth and Job Creation: Evidence from Indonesia”, Journal of International Development. Ana Luiza d’Ávila Viana is a Researcher Level 1 for the Brazilian National Research Centre (CNPq) and a retired Professor at the Department of Preventive Medicine, School of Medicine, University of São Paulo (USP), where she currently leads a national research project on policy, planning and management of health regions and networks, and supervises the work of several PhD candidates. She earned a Doctoral (1994) and a Master’s degree (1981) in Economics from the State University of Campinas, Brazil. She has a BA degree (1974) in Economics from University Candido Mendes, Brazil. She was a former Director of the Science and Technology Department of the Brazilian Ministry of Health (2011–12). Her teaching and research interests cover the following topics: social and health policies, both in Brazil and abroad; research methodology in public policies; the political economics of social protection and of social policies; social protection systems; the public and private dimensions of social policies in Brazil; and institutional aspects of social policy and of health. xx Notes on Contributors

Ilcheong Yi is Senior Research Coordinator at UNRISD. He joined UNRISD in October 2008. Born in the Republic of Korea, he was trained as both a political scientist (BA and MA from the Department of Political Science, Seoul National University, Korea) and a social policy analyst (DPhil. from Oxford University, UK). He specializes in the issues of poverty, social policy, labour policy and historical analysis of the economic and social development process. Prior to this, he was Associate Professor of Kyushu University, Japan (2004–08), Korean Foundation Visiting Professor, Department of East Asian Studies of Malaya University, Malaysia (2003–04) and Visiting Research Fellow of the Stein Rokkan Centre, Bergen University, Norway (2002–03). He also acted as external collaborator and consultant for various field research and project development of international and national organizations, such as UNRISD, the International Labour Organization, the Japanese Bank for International Cooperation and the Korea International Cooperation Agency. Athia Yumna currently works as a senior researcher at SMERU Research Institute in Jakarta, Indonesia. She holds an MSc in Economics from the University of Warwick (UK). Her research interests include social protection, poverty, health and other development issues. During 2010–12, she was involved in a study entitled “Improving Social Protection Effectiveness: Incorporating Economic and Social Risks and Gender Inequalities”, which was a collaboration between SMERU and the Overseas Development Institute (ODI). She was also a researcher in a multi-country and multi-year study on health equity and financial protection in Asia (2009–13), where SMERU was a member of a consor- tium led by the Erasmus University in Rotterdam (the Netherlands). Recently, she led a study on maternal, neonatal and child health baseline assessment in the early implementation of Indonesia’s universal health coverage scheme, which was commissioned by UNICEF Indonesia. Shufang Zhang is a health economist working at the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria providing technical support to countries on strategic resource allocation. Shufang was Project Coordinator at UNRISD, served as a Technical Adviser for China Medical Board’s health policy and systems sciences (HPSS) programmes and worked at the World Bank on poverty reduction and sustainable development. Her research focuses on health policy in the areas of health care financing, migration and health, and the evaluation of health interventions. Shufang received her Doctoral degree in Health Economics from Harvard University and Master’s degree in Environmental Economics and Policy from Duke University. List of Abbreviations and Acronyms

AD Acción Democrática (Democratic Action party, Venezuela) AFC Asian financial crisis AIDS Acquired immunodeficiency syndrome ANC African National Congress (South Africa) ARV Antiretroviral Asabri Asuransi Angkatan Bersenjata Republik Indonesia (Indonesian armed forces’ social insurance) Askes Asuransi Kesehatan (Indonesian health insurance for civil servants, retired civil servants and retired military personnel) Askeskin Asuransi Kesehatan bagi Keluarga Miskin (Indonesian health insurance for poor households) BPJS Badan Penyelenggara Jaminan Sosial (Indonesian social security implementing agency) BRICS Brazil, Russia, India, China and South Africa CAP Caixas de Aposentadorias e Pensões (Retirement and Pension Credit Unions, Brazil) CCP Chinese Communist Party CCT Conditional cash transfer CGU Controladoria Geral da União (Comptroller General of the Union, Brazil) CMS Cooperative Medical System xxi xxii List of Abbreviations and Acronyms

COPEI Comité de Organización Política Electoral Independiente (Christian Democrat Party, Venezuela) CPMF Contribuição Provisória sobre Movimentação Financeira (Provisional Contribution on Financial Transactions, Brazil) CSMBS Civil Servant Medical Benefit Scheme (Thailand) CSO Civil society organization CUPs Contracted units for primary care DA Democratic Alliance (South Africa) Dasperi Dana Kesejahteraan Pegawai Negeri (Indonesian civil servants’ welfare fund) DoH Department of Health (South Africa) DP Democrat Party (Thailand) DRC Development Research Centre of the State Council (China) DRG Diagnosis-related group DSP Developmental state paradigm DWS Developmental welfare state EMI Employee Medical Insurance EU European Union GDP Gross domestic product GFC Global financial crisis HIC High-income country HIV Human immunodeficiency virus HLEG High-level expert group IAP Institutos de Aposentadorias e Pensões (Institute of Pensions and Retirement Benefits, Brazil) ID Identity IDR Indonesian Rupiah IDSS Índice de Desempenho da Saúde Suplementar (Supplementary health care performance index, Brazil) IDSUS Índice de Desempenho do SUS (SUS performance index, Brazil) IDUs Intravenous drug users ILO International Labour Organization IMF International Monetary Fund List of Abbreviations and Acronyms xxiii

IMR Infant mortality rate INAMPS Instituto de Assistência Médica da Previdência Social (National Institute of Medical Assistance and Social Welfare, Brazil) INGOs International non-governmental organizations INR Indian Rupee IVSS Instituto Venezolano de los Seguros Sociales (Venezuelan Social Security Institute) Jamkesmas Jaminan Kesehatan Masyarakat (Indonesian health security scheme for the poor) Jamsostek Jaminan Sosial Tenaga Kerja (Indonesian workers’ social security) JPS Jaring Pengaman Sosial (Indonesian social safety net programme) KPI Key performance indicator LAPOP Latin American Public Opinion Project MDGs Millennium Development Goals MGNREGA Mahatma Gandhi National Rural Employment Guarantee Act MHI Mandatory health insurance MMR Maternal mortality rate MoF Ministry of Finance (China) MoH Ministry of Health (China) MOPH Ministry of Public Health (Thailand) MPs Members of Parliament MSAS Ministerio de Sanidad y Asistencia Social (Ministry of Health and Social Assistance, Venezuela) MSDS Ministerio de Salud y Desarrollo Social (Ministry of Health and Social Development, Venezuela) MWS Medical Welfare Scheme (Thailand) NAC National Advisory Council (India) NCMS New Cooperative Medical Scheme (China) NFHS National Family Health Survey (India) NFSA National Food Security Act (India) NGOs Non-governmental organizations NHI National Health Insurance (South Africa) NHS National Health Service (UK) xxiv List of Abbreviations and Acronyms

NHSB National Health Security Board (Thailand) NHSO National Health Security Office (Thailand) NRHM National Rural Health Mission (India) OECD Organisation for Economic Co-operation and Development OPEC Organization of Petroleum Exporting Countries PDPs Parcerias para o de Desenvolvimento Produtivo (Partnerships for productive development) PDS Public Distribution System (India) PDVSA Petróleos de Venezuela SA (state oil company, Venezuela) PHC Primary health care Poskesdes Pos kesehatan desa (village health post, Indonesia) Posyandu Pos pelayanan terpadu (integrated health post, Indonesia) PPP Purchasing power parity PSSOP Public sector system of provision PT Perseroan Terbatas (Indonesian limited liability company) Puskesmas Pusat kesehatan masyarakat (community health centre, Indonesia) Pusling Puskesmas keliling (mobile health centre, Indonesia) Pustu Puskesmas pembantu (community health subcentre, Indonesia) RMB Renminbi (Chinese yuan) RSA Republic of South Africa RSBY Rashtriya Swasthya Bima Yojana (health insurance scheme, India) RTE Right to education SA South Africa SARS Severe acute respiratory syndrome SDGs Sustainable Development Goals SDR Age-standardized Death Rate SJSN Sistem Jaminan Sosial Nasional (Indonesian National Social Security System) SRM Social risk management SRS Sample Registration System (India) SSA Sarva Shiksha Abhiyan (Education For All movement, India) SSS Social Security Scheme List of Abbreviations and Acronyms xxv

STD Sexually transmitted disease SUDS Sistema Unificado e Decentralizado de Saúde (Unified Decentralized Health System, Brazil) SUS Sistema Único de Saúde (Unified Health System, Brazil) Taspen Tabungan Asuransi Pegawai Negeri (Indonesian Civil Servant Insurance Savings) TB Tuberculosis TFR Total fertility rate TRT Thai Rak Thai (political party) UCS Unified Coverage Scheme (Thailand) UFMR Under-five mortality rate UHC Universal health coverage UNDP United Nations Development Programme URBMI Urban Resident Basic Medical Insurance (China) USD United States Dollars VHCS Voluntary Health Card Scheme (Thailand) VHI Voluntary health insurance WHO World Health Organization WRA Welfare regimes approach List of Figures

Fig. 4.1 Trend in income inequality in Thailand, 1975–2006 95 Fig. 5.1 Health insurance coverage by insurance scheme, Thailand, 1991–2009 130 Fig. 5.2 Payment mechanisms and budget for different benefit types under UCS 133 Fig. 5.3 General government expenditure on health and total health expenditure in Thailand, 2000–2013 134 Fig. 5.4 Share of health financing in Thailand from variety of public and private sources, 1994–2010 135 Fig. 5.5 Changes in health care utilization rate among UCS members, 2003–2010 137 Fig. 5.6 Proportion of UCS members and proportions of their outpatient and inpatient utilization comparing richest (Q5) and poorest (Q1) quintiles, 2003–2009 138 Fig. 5.7 Proportion of households with catastrophic health spending by quintiles, 1996–2008 139 Fig. 5.8 Estimated number of households impoverished from health care payments and the estimated trend if there were no UCS 140 Fig. 5.9 Schematic diagram of the benefits package decision process since 2010 146 Fig. 6.1 Percent of total population that voted in presidential and congressional elections, 1894–2010 167

xxvii xxviii List of Figures

Fig. 7.1 Total public and private health facilities in Brazil, 1976–2009 188 Fig. 9.1 Chinese government revenue as a percentage of GDP, 1978–2012 249 Fig. 9.2 Total health expenditure composition in China, 1979–2011 253 Fig. 9.3 Total health expenditure per capita and total health expenditure as percentage of GDP in China, 1995–2012 261 Fig. 10.1 Age-standardized death rate (SDR), all causes, all ages, per 100,000 in Russia compared to EU member countries 274 Fig. 10.2 Total per capita expenditure on health in Russian Federation and WHO European region, 1995–2013 283 Fig. 10.3 Distribution of hospital beds by region in Russian Federation, 2009 285 Fig. 10.4 Distribution of doctors by region in Russian Federation, 2009 286 Fig. 11.1 Infant mortality rate (IMR), under-five mortality rate (UFMR) and total fertility rate (TFR) in India 306 Fig. 11.2 Infant mortality rate in selected Indian states, 2013 306 Fig. 13.1 Social expenditure as a percentage of GDP in Venezuela, 1990–2005 360 Fig. 13.2 Health policy in twenty-first-century socialism in Venezuela 366 Fig. 14.1 Transformation of BPJS Health and BPJS Employment 388 List of Tables

Table 1.1 Dimensions and indicators of social policy programmes 11 Table 4.1 Medical coverage in Thailand, pre-2001–2013 (million) 108 Table 4.2 30 Baht Programme capitation rates, 2002–2013 (in Baht) 108 Table 5.1 Types of social protection programmes 123 Table 5.2 Social protection schemes in Thailand 127 Table 7.1 Selected health care coverage indicators in Brazil, 1998–2012 183 Table 7.2 Selected indicators related to coverage, finance protection and quality of health care in Brazil, before and after SUS 185 Table 7.3 The process of regulating decentralization and regionalization in the SUS, Brazil, 1990–2013 194 Table 7.4 Characteristics of the two productive health care models in Brazil 204 Table 9.1 Summary of the three social health insurance programmes 255 Table 9.2 Comparison of health status between rural and urban residents, 2006–2010 260 Table 10.1 Life expectancy, infant mortality, under-five mortality and maternal mortality in Russian Federation (selected years, 1990–2009) 271 Table 10.2 Main sources of health care financing in the Russian Federation (percent of total) 277

xxix xxx List of Tables

Table 11.1 Government health human resources in rural areas in India, 2005 and 2011 311 Table 14.1 Social Insurance programmes in Indonesia since 2015 388 Table 14.2 Health insurance coverage in Indonesia, 2012 389 Table 14.3 Health workforce in Indonesia and other countries in the region 393