Coalitions of the Wellbeing

Overview

"Why do some developing countries have more efficient health systems and better health outcomes? Rather than focus on specific policies, this book explores the broader decisionmaking environment shaped by a country's electoral system and ethnic structure. Using both cross-national statistical analysis and detailed country case studies, the politics of health is explored in three types of societies. In low ethnic salience countries (Thailand, Botswana), proportional representation (PR) electoral systems lead to superior health outcomes by encouraging broad political coalitions that target health spending evenly across the country. In high ethnic salience countries with geographically intermixed ethnic groups (Mauritius, Malaysia), however, majoritarian systems provide the incentives for ethnic groups to come together in broad coalitions and use health funds efficiently. In countries with geographically isolated ethnic groups (Myanmar, Indonesia), neither rule is superior. The theory has broad implications for electoral system design, establishing a middle ground between Consociational and Centripetal schools of thought."