Thailand 1980s - the Present: Neoliberal Ideas, Policies, and Practices - Case Study Example

Outline: I. Introduction II. Health Care Policies in Thailand III. Thailand during 1980s to Present: Neoliberal ideas, Policies and Practices a) Health Care Services b) Reasons for Financial crisis in Thailand c) Impact of Migration on Health care, Industry and Exports d) Application of Gramsci and Serageldin’s Theories IV. Conclusion V. Works Cited Health and education are some of the most crucial factors in states that are in the third world. Healthcare policies mean an array of guidelines, regulations and laws that are available to run, fund and shape the delivery of healthcare. Healthcare policies cover an assortment of issues related to healthcare such as the funding of healthcare, preventive care, long-term healthcare, as well as mental health. Most governments of the third world nations try so hard to ensure that matters regarding health care are dealt with properly but the biggest problem that they make is that the policies that they design and implement in facilitating health care services leave a lot to be desired. In this paper, we are going to discuss the political environment of Thailand and how it has affected the implementation or provision of health care. In explaining these, we will also use the Gramsci and Serageldin’s theories, in order to analyze and understand what is happening and why they are happening in that manner. The current policies of Thailand regarding political, social and economic sectors have been the biggest impediment to development especially in the matters regarding health care. In the case of Thailand, in the year 2001, the country had a worldwide coverage scheme which ensured an equitable access for all the people in Thailand even the most poorest. At a fee of 30Baht Thaksin saw to it that, every person going for consultation, the users for this health services would access registered health care. The categories exempted from this fee included children below 12years, the poor, citizens above the age of 60 years and health workers. The function of such an exemption had an effect on the health service utilization on poor people. There are numerous policies in which the former prime minister in the Kingdom of Thailand Thaksin Shinawatra ensured the implementation of distinctive health care policies which got initiated in public health and education among others. His policies had an effect on the people in Thai which as a result made him a very popular politician. Most of these policies seemed effective when it came to alleviation of poverty standards in the rural areas. Implementation of policies took place after Thaksin’s party received more votes and support from the people of Thai. He declared his determination on devoting himself to politics. Thaksin a man popularly known for being a populist ensured the spending of money on cases of subsidized agricultural loans, health care, infrastructure and education in addition to development of medium and rural programs. Thailand’s empowerment of its government by the exiled former is the reason for its rapid economic and social growth after experiencing a devastating economy as a result of the Washington Consensus links to Prime Minister Thaksin Shinawatra. With the implementation of reforms in a non-IMF fashion, Thaksin cultivated the social and human capital which had Thailand on its tracks to sustainable development. The Washington Consensus at one time represented a mantra for global policies. The introduction of neo-liberal project leads to the reinforcement of the World Bank and other authoritative positions. While the 30-Baht scheme makes its coverage in all the poor locations or areas, the free exemption only supports the older generation and those who are poor. Satisfaction and utilization can also be noted to be highest among the freely exempted lot. Most in this group specify that this policy promotes the necessary changes required so as to improve the health care state of services. Raising Funds for health care in Thailand has been one of the key problems in the health care sector. The health care expenditure in Thai increases with 3.82% of its GDP, since the year 1980 to 6.21% in the year 1998. In this period the expenditure of health per capita rose in the year 1980 (Doner 236). However, it can also be noted that 20million people in Thailand during this time had no insurance. After the declaration of the new constitution, there are still no laws that exist, which support the implementation of health policies in regard to raising funds and insurance. With increased problems of information that is asymmetric, the health care market is now trending on the wrong path since most consumers cannot come up with rational choices in regard to health services. The cost of health care in Thailand is rising at a rapid rate despite the health care system in Thailand being poorer in implementation. Thus, there is need for implemented health care policies. Health care in Thailand are provided by the Thai government through the Ministry of Health. As for the case with medical facilities, despite its increased expenses, most seem to prefer providers of private medical services, regarded to be high quality. There is a shortage of general practitioners in Thailand but the services offered are still of high quality. Health and education are some of the most crucial factors in states that are in the third world. In a state like Thailand, more of the same services are not the guarantee to increased access of health services. Thailand should be noted that it has a federal system of government where the central expenditure of the government is based on health care. Following a high growth rate in the 1980s, Thailand is today increasing its share of government allocation to services in the education and health sectors. A continued growth the years 1980s showed that the health care expenditure always accelerated more rapidly with time. However, there have been regional inequalities in Thailand because per capital of Thai’s government expenditures directed on education and health constantly remained behind in different areas of Thailand. Table showing the Regional Inequalities in Income earned in Thailand in the year 1981 Source: http://www.adb.org/publications/why-has-income-inequality-thailand-increased-analysis-using-1975-1998-surveys Regional Income inequalities: Area 1981 Overall area 100.0 Rural Sanitary District Village 86.7 Rural Villages 72.6 Urban Area Municipality 13.3 Municipal & Sanitary District 27.4 To ensure that the debt crisis in Thailand got addressed, the policies in Thai’s government applied the policies for the restructuring of the health, education facilities and other protected industries in Thai. The policies used by the officials had the World Bank backing them up, which supported the ban on imports (Doner 24). In the year 1980, the emphasis linked on how to develop the primary health rural areas. This resulted to the ministry of public health increasing the budget from 49% to 55% in 1951. The health care system that is in Thailand does not incorporate a design where the central government takes care of the health care costs. However, most of the poor families could gain free access to health care. There is the Ministry of Public Health, (MOPH) budget which accounts for 18% of the total health expenditure where most of it gets spent on tertiary and secondary levels of education and medical services in the urban areas. However, in the rural areas, most of the population uses health and educational services extensively but free of charge. Both the health and education system in the rural areas of Thailand have increased extensively and now about 80% of this population can access the health and education services. Table showing the attendance of students to schools before the implementation of Thaksin’s Policies in 2001 Sch. Attendance of student population 6-29yrs Source: http://ideas.repec.org/a/ebl/ecbull/eb-08j10009.html Yr 1980 Total 24,074935 Attending 9,280933 % 38.55 Not Attending 14,784699 % 61.41 Municipal Areas 4,214488 Non Municipal 7,342 530 M.A of Uni. 188,043 N.M.A of Uni. 89,126 Some of the reasons why the financial crisis in Thailand became worse, traces back to the government’s distribution of revenues. The government in Thailand represents frequent control by the central government, therefore most of resources and revenues got generated towards the central government’s needs. As a result, there issue got solved with inadequate revenues to be distributed to local communities in urban and rural areas. Majority of the nation’s highly concentrated wealth in the government in urban centres, which redistributed this wealth to other areas but only in small portions. Thus, the unequal distribution of revenues led to the existence of financial crisis in the state. When Thailand started adopting Thaksin’s policies on health, education this resulted to industrialization and development in most of the urban centers. However, this led to some of the most remote rural areas in Thailand becoming neglected. Most of the people from these remote locations migrated to the urban centers in such of health services, educational services for their children and work (Cherdchuchai and Otsuka 420). Migration became rampant and led to increased urban unemployment levels, overcrowding in the health and educational institutions and an in-balance in the social opportunities provided. The rural areas became isolated and as a result the industries had no source of labor. This resulted to the officials in the ministry of Industry seeking to reduce this dependence on imported components by ensuring that they encouraged the local assemblers to make purchases of the locally produced goods (Donner 236). The issue on migration is a well known activity in Thailand for many years and it as evidenced in 1980s than emigration. However, is also evident that the degree of migrating or moving from one country to another is not only influenced by capital (Massey 2). Additionally, Immigrants in a country like Thailand therefore, led to an increase high growth of the economy. Thailand also responded to this financial crisis immediately and as a result, the Japanese firms that wanted to escape their state’s increase of labor costs and the yen, flooded in Thailand (Doner 242). Table showing Active population 11yrs of age over in 1960 in the Industry: Source: http://ideas.repec.org/a/ebl/ecbull/eb-08j10009.html TOTAL MA NMA Male Female Male Female Male Female Agriculture 8,347442 8473127 131890 99119 82155552 8374008 Manufacturing 696363 612098 328819 256213 367544 355885 Construction 285741 66752 122369 30553 163372 36199 Bank/Financial Insurance 70560 38482 56204 32156 14356 6326 From the Gramscian perspective, both social and civil services seem endangered by the negative adjustments which are as a result of increased spending on poverty related issues. This theory suggests that an increase in Foreign Direct Investments would be likely to have control on the economic decisions. However, neo-liberalism changed the nature of politics and economy in Thailand (Gramsci 350). Foreign direct investment in Thailand has therefore become the key source of its increased trade but cuts on social services such as government projects resulted to the foreign investors maximizing their profits. According to Seregelding’s theory, there are certain forms of social capital which suffer from productivity, whereas there are those who may benefit from the same productivity. In these different accounts, this can be said to be solely reliant on the state and the individuals (Serageldin 5). In this case, an increase in the FDI in a social capital state only promotes the investments done in a state. According to Gramsci’s theory, the civil society can comprise of a space where the nation engaged can struggle with numerous factors that dominate the norms, ideas and values of the given society. Thailand offers a varied and fertile terrain where Gramsci’s theoretical framework is applicable in explaining the reasons why there is economic and social growth. Gramsci’s idea of ‘space and place’ appears to be designed for explaining the accommodation to the available social structures, but not resistance. According to the Gramscian notion or perspective, domination can break apart under the credence of the same unequal development processes that are critical to domination or influence. The principles of domination mark the resistance’s probability within the embodied accommodation experience to the class rule. Gramscian account of the Thailand’s ‘Red Shirt’ movement demonstrates that the seeds for distortion of Thailand’s royalist domination have been planted in accommodations embodied process to the ruling class domination. Moreover, the depth and extend of challenges to this domination are not only apparent from the reaction of the civil group movements, and the regional discomfort in the Northern and Northeastern part, but also from the discontent resistance shown by the working class women to the limitation of their consumerism. This lack of free space for operation in the country greatly hampers growth, as it appears like most individuals are against the authority. The application of an understanding of Gramscian of the civil society to Thailand lights up the aspects of civil society, which are disregarded by the liberal perspectives. Different from the liberal notions that perceive civil society as a space whereby the state is involved in a tussle with some other actors in dominance of the popular norms, values and concepts; that is civil society is a ‘contestation’s platform.’ The theory of is critical to the comprehension of civil society in Thailand. First, we find that Gramsci does not presume, like most liberal theorists, that the civil society and the state are essentially on hostile terms. But instead, there is an ‘integral association between both of them in the domination’s enforcement. Closely associated with this suggestion or proposal is the fact that some the state is supported by some segment of the civil society instead of opposing. However, this insight is critical in the context of Thailand since it draws attention to the ideological together with associational relationships that might be there between the state and civil society. Increase in salaries for people working in construction and manufacturing companies led to a positive change to the health care sector. According to Jeong and Robert in the journal of Models of Growth and Inequality (2002 p.2), when the groups who earn highly increases faster than those of the low income groups, the income levels in these groups changes and it may increase. The living standards for people in Thailand improved for those with increased salaries and could access high quality health services and take their children to the most prestigious schools in Thailand. The occurrence of migration in Thailand also served to disrupt the social atmosphere of the nation. Uncontrolled migration creates a "search after the real meanings of places, the unearthing of heritages and so forth…[as] part of a response to desire for fixity and for security of identity in the middle of all the movement and change" (Massey 5). The social barrier between rural and urban cultures became more and more enhanced, as "[unequal distribution of industrial location] promotes the idea that a larger share of the agricultural sector is an indicator of backwardness, which is a reason to pursue a more equitable industrial share". Thailand’s economic growth has not been equally distributed across all the regions in the country, especially the Northeast and North of Thailand, where poverty reduction is comparatively stagnant (Ikemoto and Takei 3). Cultural differences were then heightened by the economic tensions resulting from a widespread resentment among the middle and upper classes, which were forced to bear the financial burden for the implementation of the 30-baht scheme, which was funded through tax revenue, while unable to derive any direct benefits from the program. Opponents of Thaksin claimed that the program served primarily as an income redistribution scheme and a device to garner political support, rather than a genuine attempt to alter the basic infrastructure of social services. In conclusion, we can say that Thailand’s health care’s sector’s influence on the political, economic and social conditions since the years 1980 can be said to be improving at the moment. Thaksin’s approach lead to increased school enrolments in schools and stimulated his people’s spirits in regard to education and health. Furthermore, the economic growth in Thailand in the year 2010 only slowed due to global factors such as political uncertainty among other factors. However, Thailand’s economic, social and political conditions have now returned to normal with the growth rates now being at levels which existed before the global financial problems which began in the year 2008. As a result of supporting sensible policies in relation to economics, the new health care policies in Thailand have promoted the state’s progress towards achieving the Millennium Development Goals. With the Works Cited: "Population Growth and Economic Development: New Empirical Evidence from Thailand." IDEAS: Economics and Finance Research. Web. 20 Apr. 2012. . Cherdchuchai, S and Otsuka, K. Rural income dynamics and poverty reduction in Thai villages: Agricultural Economics. 2006, pp.409–423 Doner, Richard F. The Politics of Uneven Development: Thailands Economic Growth in Comparative Perspective. Cambridge: Cambridge UP, 2009. Print. Gramsci, A. Selections from Prison Notebooks. New York: International publishers: 1971, pp.348-357. (Notes on ‘Language, language & Common Sense’ and ‘What is man’) Ismail Serageldin. Sustainability & Wealth of nations: First steps in ongoing journey. Washington: The world- bank environment sustainable development studies & Monograph services no 5:1996 Massey, D. A Global Sense of Place: From Space, Place and Gender. Minneapolis: University of Minnesota Press, 1994. "Asian Development Bank (ADB)." Why Has Income Inequality in Thailand Increased? An Analysis Using 1975-1998 Surveys. Web. 20 Apr. 2012. . kemoto, Yukio, and Izumi Takei. Regional Income Gap and Migration: The Case of Thailand.Massachusetts: Harvard Asia Quarterly. 2006. Print. Read More