Grievance politics and technocracy in a developmental state

Publication Type

Journal Article

Publication Date

4-2024

Abstract

This article uses a process-tracing approach to understand changes inSingapore’s health sector from the start of self-rule in 1959 to the end of the COVID-19 pandemic in 2022. Singapore is a developmental state recognized for its effective management of healthcare costs and its lack of political freedom. In both respects, the ‘Singapore model’ is of interest to other cities and nations. The standard narrative is one of technocratic proficiency in a context in which civic freedoms are heavily constrained, but this article identifies the surprisingly important role of social voices at key moments. It finds episodes in which effective changes to social policies are not the product of a state embedded in an organized society, but rather are influenced by the independent organizational capacity of certain social groups providing inputs to state elites on social grievances and policy needs. Effective policy changes require a responsive state elite that — even if it is technocratically dominated, as is the case in Singapore — can listen to social claims and provide answers that are not repressive. The article conceptualizes these dynamics as ‘grievance politics’ and shows their role in explaining health reforms. It contributes to understanding global health systems and policymaking in developmental states by a fruitful cross-fertilization with social movement studies

Keywords

Social voices, Policy feedback, Healthcare policy, Health reforms

Discipline

Health Policy | Public Affairs, Public Policy and Public Administration

Research Areas

Political Science; Sociology

Publication

Development and Change

ISSN

0012-155X

Identifier

10.1111/dech.12821

Publisher

Wiley

Additional URL

https://doi.org/10.1111/dech.12821

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