By Illan Nam
This publication presents an account of milestone medical health insurance reforms that happened in Korea and Thailand, which considerably complex equitable entry and redistribution in well-being care. Thai and Korean welfare champions have been deeply trained by means of their studies as activists of their international locations' democracy routine.
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Additional resources for Democratizing Health Care: Welfare State Building in Korea and Thailand
7 In contrast to the CSMBS’ fee-for-service reimbursement system, the SSS contracted with providers on a capitation basis for both inpatient and outpatient services (Tangcharoensathien et al. 2003, 122–3; Sakunphanit 2006). Under this system, actuarial estimates assessed the cost of treatments per person per year and prescribed a budget that corresponded to the number of people enrolled with a provider or facility. By maintaining a ceiling on costs, the capitation system helped limit budget growth; consequently, although costs did increase under the SSS system over Health Regimes in Korea and Thailand 25 time, the increase on a per-patient basis was not nearly as high as that of the CSMBS.
While the consolidation of a fragmented system into a single insurer increased risk and income pooling and greater standardization of contribution rates, by itself, the merger did not produce dramatic redistributive effects. Since contribution rates were low to begin with, the gains that the new standardized rate delivered to lower-income Koreans were outweighed by what they continued to Health Regimes in Korea and Thailand 43 spend in direct payments (Kwon and Holliday 2007). Hence, while the single-payer reform strengthened solidarity, it did not address other factors—the provider payment system, low contribution rates, and physician’s incentives—that generated high levels of private financing.
Chapter 2 lays out the book’s central argument about the role of solidarity coalitions in advancing health insurance reforms in Korea and Thailand. To do so, it identifies categories of political resources that solidarity actors commanded, the contribution that each type of resource imparted to the coalition’s aggregate strengths and weaknesses, and the various actors who possessed such resources in the two countries. Next, it offers a two-part explanation for how the solidarity coalitions emerged in the two countries and why they took different forms: first, it argues that democracy movements, in particular, the student movement, were fertile structural environments for nurturing valuable and fungible political skills.