Popular perceptions of social policies in East Asia are terribly out of date. Besides, Japan, Korea, and Taiwan have rapidly established social programs that are comparable to those found in Western countries but are often still described as welfare laggards. While public expenditure on social programs is still low, it will rise rapidly as the population ages and programs mature. Commentators on the region are yet to fully grasp the fact that governments there are no longer as single-mindedly focused on economic growth as the stereotypes suggest.

Joseph Wong does a brilliant job describing and explaining the rise of universal health insurance in Korea and Taiwan. Healthy Democracies extends the pioneering works on the subject by Dong-Myeon Shin, Huck-Ju Kwon, Kuo-Ming Lin, M. Ramesh, and Yeun Wen Ku by offering new data and a fresh reinterpretation. The book does not refer to some recent publications on the subject, which is possibly the result of delays in publishing the manuscript. It is tightly organized and lucidly written. The first two chapters deal with introductory materials, followed by four solid chapters on the development of health policy in the two countries. The following two chapters, offering an explanation of the policies, form the heart of the book.

Its main strengths are the careful chronicling of policy history, detailed discussion of the policy actors and machinery, and solid analysis of political and ideational factors affecting health policy development in Korea and Taiwan. The author's explanation of the selectiveness of the early policy reforms and the universalism of the later reforms with reference to a deepening of democracy is particularly well done. His explanation of the differences in the health policy reforms in the two countries with reference to different pathways of democratization is also plausible. The book strikes a decisive blow against widespread beliefs that cultural beliefs in Asia are inimical to an expansion of the state's role in health care and social security.

Another strength of the book is its inductive approach, given the abysmal record of deductive approaches in explaining developments in the region. Instead of testing a limited number of propositions, it casts its net widely to develop a comprehensive understanding of the subject. At the end, it arrives at a conclusion that is not elegant or parsimonious but on the mark and useful. On the downside, the inductive approach limits the explanation's applicability to other countries in the region.

It would have been useful for the author to directly address similar arguments proposed by others writing on the subject. Specifically, Kwon, Ku, and Ramesh pay a great deal of attention to democratic competition in their explanatory works on the subject. Kwon's and Ku's arguments that social policies in Korea and Taiwan were shaped by political crises faced by the respective governments and Ramesh's arguments that social policies in the region are shaped by the regimes' political vulnerability are particularly relevant to the book's central argument but are not adequately dealt with.

Wong's use of democracy and democratization for explaining policy developments is also more problematic than he acknowledges. There are democratic countries in the region and elsewhere where the growth of social policies has been stunted for decades. The key to understanding social policy developments may not be democracy per se but, rather, the level of political competition and, particularly, the government's vulnerability to loss of office. A governing party without serious fear of losing election, for whatever reason, is unlikely to be motivated to launch generous social programs. The absence of a significant expansion of social security in Malaysia and Singapore in the last few decades reflects the ruling parties' confidence in their ability to remain in office.

The role of bureaucracy in social policy changes is also not paid the level of attention it deserves. One of the few elements of Korean and Taiwanese public policy on which most commentators agree is the pivotal role that bureaucracies in the two countries play in the policy formulation process. Wong does a good job describing how democratization forced public managers to pay greater attention to social issues, but they were not mere ciphers carrying out their political masters' orders. Without some innate support for universal social insurance, they would have had ample opportunities to scuttle, or at least delay, the reform proposals. Health ministries in both countries were comfortable with social insurance and found the ruling politicians' reform ideas acceptable. Contrast this to the stalemate over pension reforms in Taiwan where the conflict among different government agencies, in addition to the loggerhead between the Kuomintang Party and the Democratic Progressive Party, has made reform nearly impossible despite broad agreement over its need and general direction.

The lack of a bibliography at the end of the book is disappointing. Publishers need to realize that detailed endnotes is not a substitute for bibliography or references. All in all, this is a rigorously researched and well-written book that will be essential reading for anyone working on health policy in East Asia. I recommend it to anyone working on public policy in East Asia.