“Professional Movements” and the Expansion of Access to Healthcare in the Industrializing World

Abstract

Explanations for the expansion of the welfare state have frequently centered on the importance of left-wing political parties and labor unions. Scholars have even pointed to the rare but growing significance of social democracy in the industrializing world. Yet, in the field of healthcare, labor unions frequently oppose sweeping universalistic reforms that threaten to erode members’ existing benefits, and those most in need of healthcare in rural areas and the informal sector are often the least organized politically. In the absence of mass demands, who then is responsible for universal healthcare programs in the industrializing world, and by what means do they successfully advocate for far-reaching reforms? This article explores the role that “professional movements” played in expanding access to healthcare in an industrializing nation that was engaged in processes of democratization. Mass movements are typically composed of lay people; by contrast, professional movements are made up of elites from esteemed professions who command knowledge, networks, and access to state resources that set them apart from ordinary citizens. The account illustrates how and why professional movements are able to play such a powerful role in health policymaking in the industrializing world, points to the need for more research on professional movements in other cases and policy domains, and discusses their relevance to social change in the industrializing world.