The Expansion of Healthcare Coverage and Implications for Theories of the Developmental State

• In Event: 393 - Section on Sociology of Development Roundtables (one-hour)
  In Refereed Roundtable: Table 05. Governance, Bureaucracy and the State

Abstract

A hallmark of the East Asian developmental state was the promotion of economic growth through active engagement and collaboration with business elites and policies that focused on industrialization-led development. The developmental state model frequently involved repression of institutions classically responsible for the development of the welfare state in the west, including working class labor organizations, and prioritized state relationships with business over civil society. While recent scholarship has suggested that 21st century developmental states – driven by broad-based relationships with civil society – are beginning to give primacy to the expansion of human capabilities instead of capital accumulation, new empirical evidence suggests that healthcare rights have been a particular target of expansion, with some newly industrializing countries even making bold new commitments to universal healthcare. However, the impetus for this shift may be less broad-based than existing theory suggests. What does the recent spate of expansion of healthcare coverage in Asia mean for new theories of the developmental state, and where has this push come from? This article suggests that, in contrast to theories of the 21st century developmental state and some popular explanations of welfare state expansion, civil society has not played a lead role in putting universal coverage on the political agenda. Instead, the drive for healthcare expansion has largely been state-driven, suggesting surprising continuities with the classical developmental state literature.

Author

• Joseph A. Harris, Boston University