Kannika Thampanishvong

Impact of Universal Health Care Coverage on patient demand for health care services in Thailand

Fully implemented in Thailand in 2002, the Universal Health Care Coverage (UC) Program aimed to provide cheap access to health care services, for 30 baht (less than 1 U.S. dollar) per visit, to all uninsured Thais. In this paper, we studied the impact of the UC in Thailand on the demand for health care services using hospital level data. We found that the UC program was successful in increasing outpatient demand for health care, particularly the demand from the elderly and the poor. However, outpatient demand for health care dramatically increased during the first year of the program and faded away quickly in subsequent years. In contrast to outpatient demand, the number of inpatient visits and the number of days for which the inpatients were admitted at hospitals declined after the UC program was launched. In this paper, we offer our explanation of these phenomena, highlight problems associated with the UC program, and provide policy recommendations to improve the program.

Optimal Sovereign Debt Write-downs *

At present, the enhanced HIPC initiative and the Gleneagles Proposal for debt write-downs by the G8 are the main mechanisms used to reduce indebtedness of low-income countries. In these countries where poor governance is a key issue, it is naive to believe that the Millennium Development Goals can be achieved if the current debt relief mechanisms fail to address such problem. In this paper, we develop a model of sovereign debt write-downs, where governance problems reflect domestic distributive conflict between two classes in the society and intertemporal conflict. The main policy issue is how to design the optimal form of debt write-downs and the conditionality requirements attached to it with such governance problems in mind. To deal with the domestic distributive conflict, it is crucial that the conditionality requirements target both provision of public goods and private consumption level of the poor citizens. Addressing the intertemporal conflict problem requires the use of long-run conditionality requirements. Against such a benchmark, we then evaluate the efficacy of the current debt relief initiatives and discuss some policy implications.

Street as a Stage: A Model of Dynamic Provision of Public Goods Under the Threat of Protest

It has become increasingly common that the politically and economically weak citizens use protest as a channel through which they express their dissatisfaction with the policies engendered by the elites. This paper aims to provide a better understanding on this issue by using differential games to study whether protest could trigger some changes in public good investment under uncertainty. In this paper, we show that protest on its own is not sufficient for inducing the elites to invest more in public goods, a result that might come as a surprise to the citizens who might believe that, by protesting longer, the elites would be forced to increase their investment in public goods. The key to this result are the assumptions that the elites – the group with political power – choose policy to increase their income and to directly transfer resources from the rest of the society to themselves and the presences of uncertainty. Only when the level of public good is too low, which could trigger high dissatisfaction among the citizens and encourage them to take part in the revolution, would the elites choose to increase the investment in public goods.

Carbon Tax and Investment in Low-Carbon Technology in a Model of Co-ordination Failure

We focus on the coordination failure among domestic firms in the investment of expensive low-carbon technology, which helps reduce the amount of carbon usage and pollution. In this model the firms are charged with a carbon tax only if the total stock of carbon emission in the environment exceeds a set carbon toleration level of the government. The carbon tax depends on the number of firms which have installed the low-carbon technology - the higher is the proportion of firms who do not invest in the technology, the higher will be the probability that firms being charged with carbon tax, and the higher will be the amount of tax.

The Millenium Development Goals and Sovereign Debt Write-downs

Can sovereign debt write-downs be used to achieve the Millennium Development Goals (MDGs)? This paper shows that transparency of domestic governance determines how a sovereign debt write-down is structured to attain the MDGs. When domestic governance is transparent, an unconditional debt write-down enhances non-elites’ welfare. Without such transparency, conditions that directly link the debt write-down to public goods that improve non-elites’ welfare are required. In the latter case, in a dynamic setting, the debt write-down also has to be directly linked to the amount of new debt issued. Using our formal analysis, we evaluate the efficacy of the current debt relief initiatives and discuss some policy implications.