Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform

"Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.     

Twenty‐first century nomadic city: Ger districts and barriers to the implementation of the Ulaanbaatar City Master Plan

Since the early 1990s, Ulaanbaatar, the capital of Mongolia, has experienced rapid rural to urban migration and population growth resulting in the growth in informal settlements across the city. The informal settlements are known as ‘ger’ districts. In response to these pressures, since the 1990s, the central government has adopted a programme of land reform and metropolitan planning. These new reforms take place in the context of a unique, post‐socialist political, economic and institutional context. The land reform process has attempted to privatise land ownership, which has traditionally resided with the state. The privatisation process was initiated under the new Constitution of Mongolia, which initiated reforms in all sectors of social and economic development, and since 2003, targeted land reform in ger districts. Running parallel, a series of urban land‐use planning schemes have been introduced to frame the development of Ulaanbaatar in the context of an emerging market economy. Although master plans for urban development have been established since the 1950s, urban land‐use planning is a new concept in this emerging market economy. The aim of this paper is to trace the rationales and challenges of implementing master plans and land privatisation processes in Ulaanbaatar. Drawing on interviews with city, national and local government officials conducted in 2009, the paper focuses on the implications of these reforms for both the government and the residents of ger districts.     

The privatisation of New Zealand forests

During the 1980s and early 1990s, the New Zealand economy went through radical economic changes, overhauling almost all aspects of economic policy. The New Zealand Forest Service was not exempt from these changes. This paper describes two major aspects of that change: the way the New Zealand Forest Service, like many other state trading activities, was restructured first through corporatisation under the State-Owned Enterprises Act 1986 which has ultimately led to privatisation; and secondly through the enactment of the New Zealand Resource Management Act 1991 which has fundamentally altered environmental management in New Zealand. The Act's underlying principle is based on the principle of sustainable management. This principle forms the foundation of forest management in New Zealand. Whether the restructuring and privatisation will produce a more efficient forestry sector is an issue that the author does not address. The Crown Assets sales are an ongoing and dynamic process which still have not been completed. This is a shortened version of a chapter originally presented in her LL.M. Thesis in 1995.     

The Economy

Dissatisfaction amongst large sections of the electorate with the results of 15 years of economic reform on account of the tardy arrival of the supposed benefits of those reforms, led to the return of a centre‐left, Labour–Alliance–Green coalition in the final months of 1999. The coalition immediately set about revising some of the policies of the previous National Party administration. The privatisation of the Accident Compensation Commission was reversed; further privatisation of the diminished stock of state assets halted. Tax on incomes over $NZ 60,000 was raised, as were pay‐outs to pensioners. Interest repayment on student loans was delayed. Market rents for state houses were abolished, as was bulk funding for schools. Arts funding was increased. Government intervention in regional development was revived. Above all else, the Employment Contracts Act was replaced with legislation that would result in a revival of union power. The Prime Minister herself acknowledged New Zealand now lived in world of global magnitudes.     

Transport

Transport in the 1990s has continued the pattern of significant change begun in the 1980s. Rail, sea and air have essentially completed the process towards privatisation, with minimal government involvement in monitoring standards and safety. Roading, however, is still financially confused in its funding and management. A sharp increase in cheap vehicle imports has brought the vehicle per capita ratio to be amongst the leaders in the first world, while the highway network remains at a lesser standard. Rational road pricing, especially in its impact on major urban areas, remains the critical issue for the next decade.