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La Thaïlande connaît depuis le début des années 1960 une croissance remarquable accompagnée d'un développement économique qui se traduit par une réduction sensible de la pauvreté. En parallèle, la distribution des revenus est devenue moins inégalitaire, tout particulièrement au cours des dernières décennies. Depuis la crise financière asiatique de 1997, la protection sociale en Thaïlande s'est développée dans un cadre institutionnel en vue de réduire la pauvreté et la vulnérabilité de la population. La politique institutionnelle initiée intitulée « couverture santé universelle » s'accompagne de larges effets sur la qualité de vie de la population thaïlandaise. L'objet de cette thèse est de déterminer dans quelle mesure les politiques de bien-être social en particulier celle portant sur la généralisation de la protection sociale ont transformé la distribution des revenus dans un contexte de forte croissance économique. La problématique soulève trois questions (1) Le développement économique a-t-il conduit à accroître les inégalités ? (2) Quelles sont les retombées de la croissance économique sur les pauvres ? (3) Comment la protection sociale contribue t-elle à faire diminuer la pauvreté ? Dans cette thèse, le cadre conceptuel a été construit à partir des théories de l'inégalité et de l'exclusion sociale afin d'analyser la pauvreté, la distribution des revenus et d'évaluer la protection sociale de la santé. Nous avons mobilisé des informations issues d'enquêtes socio-économiques, de bases de données internationales et d'enquêtes directes sur le terrain pour étudier les inégalités et les conséquences de la pauvreté sur plusieurs catégories de pauvres. Les politiques publiques à destination des déshérités sont également considérées dans cette étude. Cette thèse nous permet de montrer que le modèle de croissance économique n'est plus aussi fortement orienté en faveur de la réduction de la pauvreté qu'au cours des périodes passées. Les mécanismes mis en oeuvre, tels que l'augmentation du bien-être social sont menacés, de sorte que les menaces liées à la crise économique actuelle sont de nature à affecter tout particulièrement les déshérités. Depuis 15 ans, la protection sociale est assurée à travers une politique de recouvrement des soins de santé soucieuse de réduire les dépenses de santé. L'inaccessibilité des soins demeure le problème majeur pour les plus vulnérables. En effet, la distribution des ressources publiques allouées aux pauvres est centralisée et est l'objet de dérives clientélistes. / In the last four decades, Thailand's economic development has been accompanied with great reductions in absolute poverty but not relative poverty. After the Asian financial crisis in 1997, social protection in Thailand emerged as a policy framework employed to tackle poverty and vulnerability. In particular the policy entitled Universal health coverage for all was initiated and had broad effects on the quality of life of Thai people. The goal of this thesis is to understand how social and welfare policies have shaped income distribution in a context of rapid economic growth. To carry out this scope, we concentrate on three questions: (1) Does economic development in the early stages lead to increase inequalities? (2) How does economic growth affect poverty? And (3) Can social protection alleviate the poverty? This thesis is grounded in the concepts of the theories of inequality and social exclusion. It connects the multidimensional aspects of both poverty concepts and measures with the different conceptual bases of social protection. Using series drawn from socio-economic surveys, international databases, field studies, and the assessment of social protection in health, the inequality and social impacts which affect various groups of the poor are explored. State policies targeting the poor are also included in the study. The results show that the pattern of economic growth is not "pro-poor" anymore, as it has been in some periods in the past. Mechanisms of poverty reduction, such as social welfare policies, are threatened, thus the looming economic crisis could be particularly hard on the poor. Social health protection in the last fifteen years has relied on the universal healthcare coverage policy, which is aimed at relieving the pressure of health expenditures. However, the inaccessibility of health services remains a problem for vulnerable populations. Indeed, the allocation of public resources targeting the poor stays is centralized and subject to influence from special interests.

The tax system in South Africa makes provision for every South African citizen to contribute to a greater or lesser extent to funding the National Health Insurance (NHI), either through VAT or PAYE. However, as a result of the high unemployment rate, a large gap exists between tax and non-tax contributors. The question can now be asked whether it is fair that just a small percentage of taxpayers are responsible for the total funding of the NHI. Furthermore, it could be asked whether the taxpayer is aware of the additional tax burden the NHI will impose on him/her. The purpose of this research was to investigate three countries, namely, Brazil, Spain and Germany, where some form of NHI is in operation, in order to find a possible appropriate funding model for South Africa's NHI and, ultimately, to make conclusions and recommendations based on the outcomes. It was subsequently found that, although the taxpayer should be more heavily taxed in order to fund the NHI, there are a few other possibilities for distributing the tax burden more evenly. However, the impact of the proposed adjustment to increase VAT could have a negative impact on the non-taxpayer and might contribute to greater poverty in South Africa. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014

The tax system in South Africa makes provision for every South African citizen to contribute to a greater or lesser extent to funding the National Health Insurance (NHI), either through VAT or PAYE. However, as a result of the high unemployment rate, a large gap exists between tax and non-tax contributors. The question can now be asked whether it is fair that just a small percentage of taxpayers are responsible for the total funding of the NHI. Furthermore, it could be asked whether the taxpayer is aware of the additional tax burden the NHI will impose on him/her. The purpose of this research was to investigate three countries, namely, Brazil, Spain and Germany, where some form of NHI is in operation, in order to find a possible appropriate funding model for South Africa's NHI and, ultimately, to make conclusions and recommendations based on the outcomes. It was subsequently found that, although the taxpayer should be more heavily taxed in order to fund the NHI, there are a few other possibilities for distributing the tax burden more evenly. However, the impact of the proposed adjustment to increase VAT could have a negative impact on the non-taxpayer and might contribute to greater poverty in South Africa. / MCom (South African and International Taxation), North-West University, Potchefstroom Campus, 2014

Text in English / South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care. / Sociology / M.A. (Sociology)

Text in English / South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care. / Sociology / M.A. (Sociology)