Social Policy Development Revisited: The Interplay between Push and Pull Factors in the Indonesian Healthcare Expansion

Abstract

Established theories of social policy development, such as industrialisation and power resources, have been extensively used to explain the expansion of social policy, predominantly in developed economies. We argue that they may not always be applicable in the Global South. Our article examines multiple factors at play in Indonesia’s healthcare policy expansion using qualitative content analysis of historical sources, literature, and nine interviews with key policy architects. Using the pull-and-push factor model, we examined the interactions between policy entrepreneurs and centre-right political parties in creating national healthcare policy architecture and expansion. Our findings confirm that the window of opportunity for expansion was augmented when the political party of the ruling government experienced a decline in public trust, while clientelistic motives among elites facilitated the reform process. Drawing the lesson from Indonesia, we contend push prevails over the pull factors (labour movement and cross-class alliances) in social policy development.