Cover

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Half Title, Series Info, Title Page, Copyright

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Contents

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pp. v-vi

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Acknowledgments

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pp. vii-xii

When I first set out to study a sweeping new health care program in Thailand that was being praised by the rural poor and pilloried by the rich, I never could have imagined the monumental nature of the journey I was about to undertake, the remarkable stories I would have the privilege to hear, or the incredible debts that I would owe ...

List of Abbreviations

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pp. xiii-xiv

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Introduction

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pp. 1-18

This book is about explaining historical change: how parts of the developing world transitioned from a moment characterized by what I call “aristocratic health care” to an altogether different moment characterized by “health universalism.” Prior to the 1990s, access to health care and life-saving drugs in the developing world was largely a matter of privilege. ...

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1. Democratization, Elites, and the Expansion of Access to Health Care and Medicine

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pp. 19-32

What accounts for the emergence of health rights in new democracies, and why should progressive members of elite professions—who frequently receive no benefit themselves—play such an important role in their expansion? In sociology, the power of elites has often been viewed with a mixture of contempt and suspicion. ...

Part I: Access to Health Care

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2. Thailand: Chasing the Dream of Free Medical Care for the Sick

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pp. 35-62

Thailand’s dramatic adoption of universal health care in 2001 garnered worldwide attention. The program was put into place just four years after a landmark constitution took effect amid a broader backdrop of democratic opening. The reform made major improvements to the health care system and extended access to health care to millions of citizens who had previously been without it in the unlikeliest of moments: ...

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3. Brazil: Against All Odds

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pp. 63-88

In the absence of mass demands, the story of Thailand’s Universal Coverage reform illustrates the way in which democratization empowered a professional movement of public-minded physicians working in the country’s Ministry of Public Health. In a context of heightened political competition, Thailand’s Rural Doctors’ Movement drew on privileged positions in the state to institutionalize universal health care ...

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4. South Africa: Embracing National Health Insurance—In Name Only

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pp. 89-122

Before apartheid fell, access to health care in South Africa was not a right. The country’s health care system was deeply segregated, and the vast majority of the country’s minority-white population relied on private health insurance to gain access to quality health care through the country’s network of private hospitals and clinics. ...

Part II: Access to Aids Medicine

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5. Thailand: From Village Safety to Universal Access

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pp. 125-150

Thailand succeeded in gaining control of an AIDS epidemic through an HIV prevention campaign, in which both state and civil society organizations played an important role. While the epidemic peaked in the early 1990s with over 140,000 new infections in a single year, HIV prevalence today stands around one percent (Loos 2015, 217). ...

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6. Brazil: Constituting Rights, Setting Precedents, Challenging Norms

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pp. 151-169

In 1991—in the midst of economic crisis and just one year removed from passage of its landmark health care reform—Brazil’s health minister made waves by announcing that his country would provide patients dying of AIDS with a miracle medication called AZT that could extend their lives. ...

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7. South Africa: Contesting the Luxury of AIDS Dissidence

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pp. 170-193

South Africa currently has the largest AIDS treatment program in the world, with approximately half of the nation’s seven million HIV+ people on life-saving combination antiretroviral therapy (Nordling 2016). This might seem to give cause to celebrate South Africa as a case of success in terms of AIDS treatment. ...

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Conclusion

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pp. 194-220

The shift away from “aristocratic health care” and toward universal access to health care and life-saving medicine (“health universalism”) stands as a remarkable moment in the history of the developing world. Countries with disparate laws, judicial systems, cultural and religious differences, demographic profiles, ...

Notes

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pp. 221-228

References

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pp. 229-258

Index

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pp. 259-268