Uneven inclusion: consequences of universal healthcare in Thailand

Abstract

‘Post-national’ scholars have taken the extension of social rights to migrants that are normally accorded to citizens as evidence of the growing importance of norms of ‘universal personhood’ and the declining importance of the nation-state. However, the distinct approach taken by the state toward another understudied category of non-citizen – stateless people – complicates these theories by demonstrating that the state makes decisions about groups on different bases than theory would suggest. These findings suggest the need to pay more attention to how the state treats other categories of ‘semi-citizens’. This article examines the differential effects of universal healthcare reforms in Thailand on citizens, migrants, and stateless people and explores their ramifications on theories of citizenship and social rights. While the state has expanded its healthcare obligations toward people living within its borders, it has taken a variegated approach toward different groups. Citizens have been extended ‘differentiated but unambiguous rights’. Migrants have been granted ‘conditional rights’ to healthcare coverage, dependent on their status as registered workers who pay mandatory contributions. Large numbers of stateless people, however, saw their right to state welfare programs disenfranchised following passage of the new universal healthcare law before later being granted ‘contingent rights’ through a new program.