Divergent Trajectories: Healthcare Insurance Reforms in East Asia ...

Illan Nam, Colgate University, Feb 2011Draft in progress, please do not quote or citeprobability of returning votes and could result in “wasted” resources. In a more stableelectoral environment, where existing cleavages already divided the electorate, detachingvoters is more costly. In this environment, sweeping universal benefits may not yield thesame efficacy at wooing voters than in a more fluid party system. Thus, the costs ofmore universal policies may not be worth the narrower benefits. Instead, a policy thattargets benefits at specific constituencies whose loyalties a party may want to attract orreinforce may be more cost-effective.CONCLUSIONThis study of healthcare reform outcomes in middle-income developingdemocracies generates a number of interesting theoretical possibilities. First, it suggeststhat globalization can elicit demands for compensatory policy, but the form of thesedemands depends on whether the structure of the domestic political economy mediatesthe pressures of globalization in such ways as to foster cross-class solidarity. The studyalso elucidates that power resources may reside in more transient organizational formsthat are not as institutionalized as they emerged in the post-WWII advanced industrialeconomy landscape. Nonetheless, the mobilization of these organizational resources bysomewhat different class actors appears to make a difference in shaping policy outcomes.Second, the study suggests that there is further room for studying the effects of partysystem institutionalization. While we are led to believe that well-institutionalized partiesand party systems are more conducive to greater accountability, stability, and moreequitable outcomes, the outcome of the cases here suggest that in perhaps intermediatezones of institutionalization – where parties systems are weakly institutionalized but33