The following was written as a commentary on an article we published in our Spring 2023 issue, “’Comprehensive Healthcare for America’: Using the Insights of Behavioral Economics to Transform the U. S. Healthcare System,” by Paul C. Sorum, Christopher Stein, and Dale L. Moore. This commentary should have appeared alongside that article. We apologize to the authors and our readers for the error.

Health insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care.

What explains the passage of Thailand's landmark universal healthcare (UHC) policy? In separate contributions, Selway and Harris emphasized the role of electoral rules and political parties, on one hand, and “professional movements” of developmentally minded state bureaucrats on the other. Which is correct? In this article, Selway and Harris respond to each other's work. While Selway agrees that the actions of the professional movement constitute an underappreciated necessary condition for universal healthcare in Thailand, he argues that Harris overstates the role of the movement in implementation. Harris defends his position and maintains that an institution-focused account is insufficient, arguing that the actions of Thailand's Rural Doctors’ Movement not only explain universal healthcare but also gave rise to the very electoral rule changes that Selway argues were so critical to facilitating universal coverage. Selway responds to these criticisms, and the two researchers jointly consider implications for causation, qualitative research, and policymaking theory.

A sizeable proportion of households is forced to share single long-lasting insecticide treated net (LLIN). However, the relationship between increasing numbers of people sharing a net and the risk for Plasmodium infection is unclear. This study revealed whether risk for Plasmodium falciparum infection is associated with the number of people sharing a LLIN in a holoendemic area of Kenya. Children ⩽5 years of age were tested for P. falciparum infection using polymerase chain reaction. Of 558 children surveyed, 293 (52.5%) tested positive for parasitaemia. Four hundred and fifty-eight (82.1%) reported sleeping under a LLIN. Of those, the number of people sharing a net with the sampled child ranged from 1 to 5 (median = 2). Children using a net alone or with one other person were at lower risk than non-users (OR = 0.29, 95% CI 0.10–0.82 and OR = 0.47, 95% CI 0.22–0.97, respectively). On the other hand, there was no significant difference between non-users and children sharing a net with two (OR = 0.88, 95% CI 0.44–1.77) or more other persons (OR = 0.75, 95% CI 0.32–1.72). LLINs are effective in protecting against Plasmodium infection in children when used alone or with one other person compared with not using them. Public health professionals should inform caretakers of the risks of too many people sharing a net.

China has achieved nearly universal social health insurance (SHI) coverage by implementing three statutory schemes, but gaps and differences in benefit levels are apparent. There is wide agreement that China should merge the three schemes into a universal and uniform SHI. However, data on the medical expenses of all inpatients in 2014 at a public Tier-three hospital suggests that supply-induced demand (SID) is a serious concern and that, under the design of the current schemes, a higher benefit level has a greater impact on the total expenses of insured patients. Thus, if SID is not effectively controlled, a universal and uniform SHI may be more harmful than beneficial in China. Finally, we suggest that China should substitute the existing fee-for-service design with a suite of bundled provider payment methods; furthermore, China should replace its current system of pricing drugs that encourages hospitals and doctors to use costlier medications.

In light of the declining pension coverage of low-income workers, policy makers have discussed requiring all employers to offer individual retirement accounts, similar to defined contribution plans. How likely to participate are workers who currently do not have access to a pension plan? We address this question by using plausibly exogenous variation in pension-plan availability to estimate the determinants of participation in a standard selection on unobservables model. We find that currently uncovered low-income workers are fairly likely to participate in a newly offered plan, yet they are much less likely to do so than currently covered workers.