HEALTH SYSTEM DESIGN AND GOVERNANCE IN INDIA AND THAILAND

Abstract

This dissertation focuses on the role of policy design in managing governance failures inherent in the healthcare sector. The dissertation argues that distinct from any role governments have in financing and/or delivering services, they must actively manage the health sector to overcome these failures. This is accomplished through a framework of policy tools, developed in this dissertation, which targets the source of specific governance failures. These tools are designed to place a system of counterweighing incentives and disincentives on three key stakeholders (i.e. users or patients, healthcare providers, and third-party payers), to shape their economic behavior and interactions. The dissertation argues that the extent to which these tools are actively used by governments to manage agency relationships between key stakeholders in a health system, it helps manage governance failures, and moderate costs. This proposition is examined through comparative case studies of India and Thailand