Date of Award

8-26-2024

Degree Type

Thesis

Degree Name

Doctor of Philosophy (PhD)

Discipline

Social Sciences

Department

Sociology and Social Policy

First Advisor

Prof. KÜHNER Stefan

Second Advisor

Prof. REN Chunhui

Abstract

This dissertation compares the causal mechanisms by which healthcare and pension systems in Indonesia have been developed. Despite their shared historical trajectories, the health reform emerged successful, while the pension reform faltered. The study employs process tracing to dissect the specific processes through which the Indonesian production regime and political bargains in 1998–2015 influenced these reforms. It commences with the generation of ideal-type mechanisms based on relevant studies, which are then tested in different cases. The researcher then connects the theoretically expected causality with fieldwork data, reconstructing a revised graph of causal mechanisms that links the crisis and reforms/inertia for theory-building.

Findings suggest that healthcare and pension reforms largely fail to satisfy ideal-type mechanisms based on the power resources logic. Instead, this study identifies causal pathways driven by the policy entrepreneurs' cooperation as the core explanatory mechanism for studied cases. This mechanism highlights the interaction of welfare bureaucrats and Academic Administrative Entrepreneurs (AAE), who hold secure positions within public administration institutions regardless of political-economic changes, in facilitating policy solutions that align with political interests. While the policy entrepreneur cooperation mechanism represented a causal reform process, there needed to be an explanation for how policy entrepreneurs could (not) effectively convince policymakers to adopt reform. The modularization analysis fills the gap by identifying additional mechanisms that outline the causal relationship between key actors' activities and the institutional context that enabled or constrained policy entrepreneurs' space for action.

The modularization analysis uncovers fascinating dynamics in the case of Indonesian healthcare reform. It reveals that the successful implementation of health reform in the United States, which bolstered President Obama's political credibility, played a pivotal role in the Indonesian healthcare reform advocated by AAE. Citing Obamacare as a reference during the lobbying process, AAE convinced relevant stakeholders to adopt the healthcare reform as a solution to diminish persistent unfavorable perceptions of the ruling right-center wing party because of corruption scandals. These tactics effectively enhanced the party's popularity in preparation for the 2014 election. This case serves as a compelling example of how policy reform experiences from external contexts can be assimilated domestically to address a domestic political concern, demonstrating a policy learning-driven interest-interdependence mechanism.

In the meantime, the success of health reform, which notably does not yield a bandwagon effect for pension reform, has illustrated the window of resistance opportunity mechanism. It explains how the inability of the AAE, who has a public health background, to resolve the deadlock between opposing parties has increased the power of stakeholders who oppose pension reform, allowing potential losers to effectively block the pension reform plans. The other variance of additional mechanisms stimulating the outcomes is detailed in section 8.3.

This study has several significant contributions to social policy and process tracing literature. Not only does a comparative and process-oriented analysis of Indonesian healthcare and pension offer new perspectives on the factors contributing to policy reform, but the case studies also showcase the diverse causal mechanisms across different pillars of social policy within the same historical context.

Language

English

Recommended Citation

Yuda, T. K. (2024). Process-oriented explanation of institutional changes: Comparative cases of national health and pension system reforms in Indonesia (Doctoral thesis, Lingnan University, Hong Kong). Retrieved from https://commons.ln.edu.hk/otd/232/

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