Although critical support for health from strategic interest groups persisted over
the period 1970–1996, the relative power of these interest groups was constantly
evolving50. Between 1970 and 2000, political parties were not strong and most
governments were coalitions. As a consequence, the bureaucratic elite or technocrats
(military and civilian) played a significant role in policy formulation at
the national level and in the translation of policy into effective implementation.
However, the past two decades have seen a decline in the power of the bureaucratic
elite and a related rise in the power of the economic elite, either directly
or through their influence on political parties and government. With the landslide
victory of the Thai Rak Thai party in 2001, the commercial economic elite
started to play a significant role in setting the policy agenda: the so-called
populist policies, advocating for the rights and interests of ordinary people in
rural areas to obtain political advantages. This benefited health; in fact it was a
political decision to put universal health care coverage on the election campaign
agenda in 200151.
Other significant groups supporting the health agenda included the media,
nongovernmental organizations (NGOs) and professional groups. Informal
policy groups were also significant. The Rose Garden group, convened monthly
for the last 20 years, is a classic informal policy group, closely linked with the
Rural Doctors Society of Thailand (Box 7.3). Various policy agendas were