At the dawn of the 21st century, the United States of America focus was on the continent of Asia region. US-China geo-strategic rivalry or competition had a “buzz word” that propagated by the media, opinion makers and policy architects around the world. This research is titled Eagle vs. Dragon: Geostrategic Rivalry and Political Ambitions of the United States and China. It involves analysing the dynamics of the US-China competition and its broader repercussions across Asia. The research will further examine the great power competition in the Asia region, where the two great powers compete for geostrategic advantage and to achieve national goals and objectives. China has confidence in achieving success, and the USA believes in victory, which will bring new challenges and opportunities for Asian regional nations. This research paper is firmly rooted in the realist tradition of International Relations and argues that both powers act as the main actors because of their national interests, security concerns, and aspirations to power, though in different ways and with distinct strategic approaches. The obstacle of this study will be attempting to discover the research, how the US-China Geostrategic competition impacts and shifts the dynamics of the Asian surface, especially in the Middle East, South Asia, Southeast Asia, Central Asia, and how both great powers secure the current challenges like (3ds) Debt, Data, and Dominance. Finally, the paper concludes that the US China competition is altering regional balances and the world power structure, and that strategic rivalry is the hallmark of modern international politics, with dialogue, crisis management, and regional integration being the most effective measures to reduce the risks of conflict.
Various stories experience the community complained about the services that have been provided by the Door Integrated Investment and Licensing Office (DPMPTSP) of Donggala regency of Central Sulawesi ProvinceFor a long time the community complained about the implementation of license services that felt very far from his expectations. The purpose of this study was to determine the quality of service for fishery sector investment permits at the Investment Office & PTSP, Donggala Regency, Central Sulawesi Province. The research method uses a qualitative descriptive approach. Determination of informants is done purposively. Collecting data using observation, and interviews. The results of this study use 5 dimensions in service quality, namely: (1) Tangibles (Physical Evidence), the results of research in this dimension indicate that the physical evidence in public services is still inadequate in terms of facilities and infrastructure. which exists. (2) Reliability, the results of research in this dimension are quite good, judging from the HR owned by the office. (3) Responsiveness, the results of this dimension study indicate the lack of responsiveness possessed by employees in the office. (4) Assurance, the results of this study indicate that the ability or friendliness of the employees in the office is good in increasing community satisfaction. (5) Empathy, these results show that the dimension of empathy in service quality is very necessary so that the people who carry out the management of the office feel appreciated.
Political institutions and public administration - Asia (Asian studies only)
Because many people may not read articles very carefully, it may be better for them to be short and focused. On the other hand, longer articles give scholars more time to explain their research. It is unclear which format is best.
Political science (General), Political institutions and public administration - Asia (Asian studies only)
This article shows how motorcycle taxi drivers in Yogyakarta, Indonesia deal with labour insecurity, tighter competition, minimum social welfare, decreased tariff and bonuses and longer working hours. The article finds that drivers employ diverse strategies to obtain more orders and therefore also more income. Drivers use prohibited mobile application-based technologies, which resemble those of their platforms, as well as non-technological strategies to boost their account’s performance. The article argues that whereas these prohibited practices can be understood as everyday resistance (Scott 1985), as oppositional acts against the holders of power and capital, they are also pragmatic survival tactics. Furthermore, the article shows that although the drivers’ resistance is individual, their knowledge and strategies are sourced and shared collectively through social media platforms. Being widely distributed between drivers and commonly applied by drivers, these strategies have nonetheless not been able to transform driver-company relationships in any significant way.
Political institutions and public administration - Asia (Asian studies only), Social sciences and state - Asia (Asian studies only)
Wesley Kaufmann, Reggy Hooghiemstra, Mary K. Feeney
Firms across the globe are affected by red tape, but there is little academic research on how country‐level institutions shape red tape perceptions. Drawing on institutional theory, we argue that a variety of formal and informal country‐level institutions affect perceptions of red tape in the private sector. We test our hypotheses using six data sources, including the World Economic Forum and the World Bank. Our results indicate that red tape is weakly associated with a country's level of formalization and rule enforcement effectiveness and more prevalent in federal as opposed to unitary states. As for informal institutions, we find that red tape perceptions are more pronounced in countries with an increased conservative political ideology, higher levels of corruption, and cultures that emphasize individualism and uncertainty avoidance. We conclude with a discussion of the implications for theory and practice.
В статье рассматривается космологическая модель тибето-монгольского буддизма, представленная в ойратском переводе одного из наиболее распространенных буддийских ритуальных текстов — «Сутры о восьми светоносных неба и земли». Эта сутра, переведенная Зая-пандитой Намкай Джамцо по просьбе супруги Батура-хунтайджи Юм Агас в середине XVII в., относится к апокрифическим сочинениям, однако в традиции монгольских народов она всегда считалась истинным словом Будды. Цель статьи — анализ модели буддийской космологии, представленной в этой сутре, с использованием текстологического и сравнительно-сопоставительного методов. Результаты. Проведенный анализ одного из ойратских списков сутры показывает, что в описываемой в тексте модели мироустройства можно выделить несколько составляющих. Первая относится к космологии классического буддизма, подробно описанной в сочинении Васубандху «Абхидхармакоша», и имеет индийское происхождение. К ней же можно отнести астрономическую концепцию двадцати восьми созвездий-накшатр и девяти планет, а также некоторые из классов обитателей буддийской вселенной. Вторая составляющая включает концепты китайской астрологии, а именно: астрологическую диаграмму золотой черепахи, включающую животных двенадцатилетнего цикла, и восемь триграмм, связанных с разными стихиями. К последнему компоненту можно отнести мифологемы автохтонной тибетской культуры, относящиеся к обитающим в одном пространстве с людьми сверхъестественным существам — нагам (тиб. klu), духам ньен (тиб. gnyan) и хозяевам местности (тиб. sa bdag). В классификации нагов очевидно также индийское влияние, поскольку в нее включены восемь великих нагов, известные в классическом буддизме, и пять каст нагов, соотносимые с социальной системой традиционного индийского общества. Обширная классификация хозяев местности, представленная в сутре и легшая в основу известного астрологического сочинения «Вайдурья-карпо», в ойратском переводе включает имена, которые отсутствуют в привлеченном для сравнения тибетском тексте из сборника «Сундуй». Это свидетельствует о том, что Зая-пандита при работе над переводом привлекал другую тибетскую редакцию сутры.
History of Asia, Political institutions and public administration - Asia (Asian studies only)
Сказки о животных — древнейший жанр устного творчества. Генетически они восходят к мифам о животных, которые были порождены стремлением человека к познанию окружающего его мира. Мифы имели магическое значение для человека, который полагал себя состоящим в кровном родстве с животными и верил в то, что присущие ему черты характерны и для животных. Определяющими особенностями сказки о животных как жанра являются система персонажей, трюк как основа сюжета и диалог, создающий драматургию события. Сказки о животных являются органичной частью сказочного эпоса многих народов, в том числе и ойратов Синьцзяна КНР, в котором сказки о животных представлены в большом количестве. В фольклорных сборниках и в периодических изданиях на «ясном письме» опубликовано более ста образцов мифов и сказок, в которых главными персонажами выступают животные. Одним из основных персонажей таких сказок является лиса. Цель статьи — определить круг текстов сказок, в которых действующим персонажем выступает лиса, и раскрыть разные характеристики лисы как трикстера. Новизна работы заключается в том, что сказочный фольклор ойратов Синьцзяна, в том числе и сказки о животных, не введены в научный оборот и не были объектом исследования в российском монголоведении. Выводы. В большинстве сюжетов в цикле сказок о животных-хитрецах представлена лиса. Следует отметить, что этому персонажу присущи как хитрость, так и глупость. Как видно из представленного материала, лиса далеко не всегда одерживает верх над другими персонажами, но достаточно часто становится их жертвой.
History of Asia, Political institutions and public administration - Asia (Asian studies only)
The era of local autonomy, along with laws 32 and 33 – which become effective in 2004 – has resulted in new rights and responsibilities for each local government. One of the rights and responsibilities of each local government is to manage its own resources. In this new era of local autonomy, resource management to be more efficient, each local government must implement a quality control system. A quality control system must utilize: human, facility, technological resources, plus sound procedural practices.
Political institutions and public administration - Asia (Asian studies only)
This paper describes the characteristics of Kim Jong-un’s leadership primarily through the analysis of the tone observed in Rodong Sinmun, the official organ of the Central Committee of the Workers’ Party of Korea (WPK). It has described five characteristics of the Kim Jong-un administration. The first characteristic is preference for fast-paced action. While there are considerable overlaps with previous studies, it is possible to clearly identify aspects that are different from the Kim Jong-il administration. The second characteristic is Kim Jong-un’s tendency toward pragmatism. He has repeatedly criticized “formalism” during his field inspections. Third, a new tendency to place greater importance on the policy-making process has become apparent. In addition to the plenary sessions of the Central Committee, meetings of the WPK Politburo Presidium, and Central Military Commission of the WPK are now convened, albeit irregularly. Fourth, obsession with certain specific issues is also characteristic of Kim Jong-un. His areas of concern are apparent from his works and from reports on his activities. These include science and technology, education, children, households, and families, the ilkun [executive staffs], buildings, vehicles, the air force, physical education, the Internet, and diversification of foreign trade. Lastly, the shift away from Songun is evident. The Kim Jong-un has increasingly distanced itself from the army-first Songun politics that symbolized the Kim Jong-il period. Kim Jong-un no longer mentions Songun. The National Defence Commission, which was the command center for the Songun system, was disbanded by an amendment to the Constitution.
Political institutions and public administration - Asia (Asian studies only), Social sciences and state - Asia (Asian studies only)
David Adi Susilo, Retno Sunu Astuti, Budi Puspo Priyadi
This study aims to determine the role of stakeholders in the regulation and guidance of street vendors in Tlogosari Kulon Village, Pedurungan District, Semarang City and to identify inhibiting factors in the implementation and management of street vendors. This research method uses descriptive qualitative, by collecting observational data, interviews, library research and documentation, interview techniques conducted to several informants including the Semarang City Trade Office, Semarang City Police Satpol, Tlogosari Kulon Urban Village, Street Vendors (PKL) in the Kelurahan Tlogosari Kulon and the Tlogosari Kulon Community. The results showed that the role of the Semarang City Trade Office as a policy creator, coordinating with other agencies and PKL Tlogosari Kulon, as well as building PKL Shelter Suryokusumo Market. The role of the community as an implementator is to provide active input in the regulation or preparation of public policies in the regulation and guidance of street vendors, both directly and indirectly. While the inhibiting factors are lack of effective communication, lack of human resources and a fragmented bureaucratic structure.
Political institutions and public administration - Asia (Asian studies only)
Penelitian dengan judul “Best Practice” Implementasi Model Kebijakan Pengelolaan Kebijakan Sampah Perkotaan” ini difokuskan pada implementasi model terbaik dalam kebijakan pengelolaan sampah perkotaan dengan lokus penelitian di Kota Padang dan Kota Payakumbuh. Sumber pembiayaan kedua kota best practice ini berbeda, Kota Padang dengan implementornya Dinas Kebersihan dan Pertamanan Kota Padang bekerjasama dengan PDAM Kota Padang dalam bentuk retribusi. Sedangkan pengelolaan sampah Kota Payakumbuh merupakan bentuk kerjasama antara Kota Payakumbuh, Kota Bukittingi dan Kabupaten Lima Puluh Kota dengan pembiayaan yang dianggarkan pada APBD Propinsi Sumatera Barat. Penelitian ini sendiri akan menjawab pertanyaan penelitian tentang bagaimana gambaran umum terkait dengan kebijakan persampahan? bagaimana implementasi model kebijakan persampahan? dan bagaimana rumusan model terbaik kebijakan persampaham di perkotaan? Metode penelitian menggunakan pendekatan kualitatif dengan teknik pengumpulan data melalui wawancara mendalam dan kelompok diskusi terfokus serta analisis terhadap dokumen pembiayaan kebijakan sampah. Sehingga dihasilkan kesimpulan bahwa pengelolaan sampah di kota Padang maupun kota Payakumbuh sama-sama belum efektif meskipun sumber pembiayaan pengelolaannya berbeda. Dalam implementasinya pada dua lokasi penelitian masih banyak ditemui kendala baik dari sisi implementor maupun dari sisi target grupnya. Sehingga model kemitraan yang paling rasional di dua lokasi adalah model implementasi mekanisme kerja mengutub (pooled) yakni masing-masing pihak (pemerintah-swasta) tidak saling tergantung satu sama lain dalam melakukan delivery mechanism atas keluaran kebijakan yang dihasilkan. Koordinasi yang dibutuhkan sangat minimal, dalam bentuk pembagian tugas yang jelas di awal ketika implementasi akan dilakukan. Setelah pembagian tugas disepakati maka masing-masing pihak dapat bekerja sendiri-sendiri untuk menjangkau kelompok sasaran sesuai dengan tugas masing-masing.
Political institutions and public administration - Asia (Asian studies only)
This article investigates the bureaucratisation of Islam in Brunei and its interlinkages with socio-cultural changes. It elucidates how realisations of state-enforced Islamic orthodoxy and purification produce locally unique meanings, while simultaneously reflecting much broader characteristics of the contemporary global condition. The article first introduces a theoretical perspective on the bureaucratisation of Islam as a social phenomenon that is intimately intertwined with the state's exercise of classificatory power and related popular processes of co-producing, and sometimes appropriating symbolic state power. Second, it outlines the historical trajectory of empowering Brunei's national ideology, Melayu Islam Beraja (MIB). It then explores social imaginaries and bureaucratic representations of “deviant”-declared practices, before illustrating how these practices become reinvented within the parameters of state power as “Sharia-compliant” services to the nation state. Simultaneously, national-religious protectionism is paradoxically expressed in thoroughly globalised terms and shaped by forces the state cannot (entirely) control. Newly established Sharia-serving practices become culturally re-embedded, while also flexibly drawing upon multiple transnational cultural registers. In the main ethnographic example, bureaucratised exorcism, Japanese water-crystal photography and scientisation fuse behind the “firewall” of MIB. These hybrid pathways to orthodoxy complicate the narratives through which they are commonly framed.
International relations, Political institutions and public administration - Asia (Asian studies only)
Attempting to create greater understanding of the political dynamics that influence domestic disaster relief and management (DRM) in Thailand, this article takes a closer look at these dynamics by outlining the main actors involved in flood-related DRM. It acknowledges the importance of international and military actors but emphasises the role of national and subnational authorities. The article then identifies the central issues of DRM governance as capacity and bureaucracy and discusses these through a chronological assessment of the flood crisis in Thailand in 2011, interweaving the colourful domestic politics with various political cleavages and dichotomies, and thereby distinguishing between three main dichotomies which it considers as the central drivers of the political dynamics and institutional development of DRM. These issues can be summarised as old versus new institutions, technocracy versus bureaucracy and centralised (but with direct people-orientation through greater channels of citizenry participation) versus decentralised bureaucracy with an indirect orientation towards people.
International relations, Political institutions and public administration - Asia (Asian studies only)
While the share of immigrants as apercentage of theUKpopulationhas increased steadily since the 1950s, it was not until the early 2000s that the descriptive representation of such new citizens in the House of Commons became more proportional. Focusing on Members of Parliament with a “Black or Asian Minority Ethnic” background in the three Parliaments between 2001 and 2015, we examine the extent to which these legislators’ parliamentary behaviour was influenced by their partymembership, legislative experience, “immigrant generation” and constituency demographics. Based conceptually on a sociological “mobilities” framework and Fenno’s work on “Home Styles” in the US Congress, we perform a dictionary-based content analysis of over 23,000 parliamentary questions for written answer. Comparing first-generation immigrants and the immediate descendants of such immigrants, we find that the content of questions reflects a relatively strong concern for transnational mobility amongst the former and a stronger focus on questions of social mobility in the UK in the latter group. Having been the origin of significant levels of emigration to non-European destinations in previous centuries, European states have become the destinations for large-scale immigration from non-European societies since the Second World War. Great Britain is a case in point: the number of foreign-born residents – socalled “first-generation immigrants” – in England and Wales nearly quadrupled from approximately 1.9 million (4.5 per cent of the “usually resident” population) in 1951, the first census after the Second World War, to around 7.5 million (13 per cent of the population) in the latest census of 2011.1 While the arrival of a large number of people with transnational biographies is not extraordinary, Great Britain differs frommany other European countries in one crucial respect: most of its early post-war immigrants arrived from Commonwealth States and therefore had full citizenship rights on arrival, including voting rights and the right to stand for 1 Office for National Statistics. Non-UK Born Population of England and Wales Quadrupled Between 1951 and 2011 (17 Dec. 2013), in: Census Analysis, Immigration Patterns of Non-UK Born Populations in England and Wales in 2011. URL: http://www.ons.gov.uk/ons/rel/census/2011census-analysis/immigration-patterns-and-characteristics-of-non-uk-born-population-groups-inengland-and-wales/summary.html (13 June 2015). 84 | Lucas Geese, Wolfgang Goldbach and Thomas Saalfeld election. Nevertheless, it was not until 1987 that the first four Members of Parliament (MPs) claiming a “Black or AsianMinority Ethnic” (BAME) backgroundwere elected to the House of Commons. At the time this “Gang of Four”2, all members of the Labour Party, constituted approximately 0.6 per cent of all MPs. When the Commons met for the first time after the general election of 2015, this share had increased approximately tenfold to some 6 per cent of all 650 Members (Table 1). Despite this increase in “descriptive representation” (see below), the political underrepresentation of BAME groups in the United Kingdom continues, as is the case in other liberal democracies. The present study seeks to explore aspects of, and differences among, the behaviour of MPs with a BAME background in the Parliaments elected in 2001, 2005 and 2010 (i.e. between June 2001 andMay 2015). Empirically our study is based on the content of parliamentary questions for written answer, which many MPs generate in large numbers. They will serve as indicators of the issues MPs promote in the chamber, or emphasise in their oversight activities vis-à-vis the government. Our aim is to highlight variations within the group of BAMEMPs rather than focusing on similarities and differences between this group and MPs of European descent. Therefore we are not comparing MPs with a BAME background to MPs without such a background. This shifts the analytic focus to some biographical factors such as “immigrant generation” or parliamentary experience on the one hand and elements of the political opportunity structure in which the BAME MPs operate on the other (e.g. MP’s party membership or socio-demographic composition of the electoral district). The emphasis of this study is not on single legislators and their individual life stories but on a few group characteristics that will be used for exploratory statistical analyses. The advantage is greater generalisability, the drawback is a loss in biographical granularity. Our data is far from carefully reconstructing the life-courses especially of the “first generation” of non-European immigrants in the House of Commons.3 Nevertheless, it carries some key information on the personal experiences, political preferences and structural factors empowering or constraining BAME MPs, which have been found to be significant influences on parliamentary behaviour: This includes the fundamental distinction whether the MPs are immigrants themselves, or whether they are the sons or daughters of immigrants, as the latter often display weaker affective ties to their ancestral “home2 These were Diane Abbott, Paul Boateng, Bernie Grant and Keith Vaz. 3 Some data connecting the politicians’ biography in their home countries with their career in their countries of residence will become available for the United Kingdom and seven other European countries (Belgium, Germany, Greece, France, Italy, the Netherlands and Spain) in 2017 when “PATHWAYS” (www.pathways.eu) a large comparative research project delivers some more finely granulated data on personal backgrounds. Mobility and Representation | 85 lands” than their parents.4 We also use information about the party an MP represents. After all, political parties are the primary contexts of political socialisation, provide and constrain opportunities for political careers and select thosewho represent them in Parliament. Not least, our exogenous variables include the context of electoral competition and the type of demands directed at MPs, which is partially shaped by the socio-demographic makeup of their constituencies.5 Compared to other studies in this volume, we find that the institutions in the new country of residence constitute very powerful constraints creating strong incentives for MPs with a BAME background to maintain a clear local or national focus. Although we may discover traces of “rooted cosmopolitanism”6 in the parliamentary speeches of minority MPs with a BAME background, they clearly constitute a contrast to the artists, bankers and other groups analysed in this volume where ambiguitymay, on occasion, have been an asset. Caseswhere British BAME MPs overtly or covertly represent the interests of ethnically related foreigners or receive foreign donations from such countries are highly exceptional and may be drawn to the attention of the Parliamentary Commissioner for Standards.7 Migration, Representation and Mobilities The present study is in the tradition of work that treats the migratory and ethnic background of MPs as consequential for their behaviour in the legislature, in 4 The importance of the difference especially between immigrants and the “second generation” of their descendants is well documented in sociological and historical research. In sociology, see Richard Alba and Victor Nee (eds.): Remaking the American Mainstream. Assimilation and Contemporary Immigration. Cambridge, MA 2005; Alejandro Portes and Rubén G. Rumbaut: Immigrant America. A Portrait. Oakland, CA 42014. In historical research, see, amongstmany others, Eric L. Goldstein: The Great Wave. Eastern European Jewish Immigration to the United States, 1880–1924, in: Marc Lee Raphael (ed.): The Columbia History of Jews and Judaism in America. New York 2005, 70–92. 5 Regarding the last two variables, see, for example, Thomas Saalfeld: Parliamentary Questions as Instruments of Substantive Representation. Visible Minorities in the UK House of Commons, 2005–10, in: Journal of Legislative Studies 17 (2011), 271–289. 6 Sidney Tarrow: Rooted Cosmopolitans and Transnational Activists, in: id. (ed.): Strangers at the Gates. Movements and States in Contentious Politics. Cambridge 2012, 181–199. 7 See, for example, Emily Dugan: Keith Vaz Reported to Parliamentary Standards Commissioner over Lobbying Visa Officials for Controversial Cricketing Tycoon, in: Independent (25 July 2015), URL: http://www.independent.co.uk/news/uk/politics/keith-vaz-reported-to-parlia mentary-standards-commissioner-over-lobbying-visa-officials-for-controversial-cricketing-tycoon10303541.html (7 Aug. 2015). 86 | Lucas Geese, Wolfgang Goldbach and Thomas Saalfeld their electoral district or vis-à-vis the wider attentive public.8 MPs of immigrant origin bring an element of strong “mobility”9 to deliberations in the chamber. This experience of mobility – or “motility” as outlined in the introduction to this volume – affects BAME legislators in the House of Commons in at least two ways: First, immigrant MPs have personally experienced “horizontal” trans-border mobility, involving the arrival in anewsocial, economic andpolitical environment. In this context they often had to overcome “historical political subordination” (e.g. as residents of former British colonies), “low de facto legitimacy”10 and possibly discrimination – not only in the work place, but also within organisations such as political parties or trade unions.11 If their background matters at all to their political attitudes and behaviour, they face a complex task once they stand for elected office: they are only likely to get selected as candidates by their parties and elected by a plurality of the voters in their respective districts, if they can claim to represent all residents of their locally defined constituencies. This leads to different strategic options for “handling” their ethnicity: at one end of a representational continuum they may have incentives to suppress their own background;12 at the other
An analysis of health system reforms in recent decades shows an apparent pendulum phenomenon. In times of macroeconomic adjustments, the pendulum swings to contain expenditures, suppress rights, and open the market, under the argument that competition improves quality. In this context, primary health care (PHC) is seen as a selective policy for excluded populations. Meanwhile, in favorable political and economic conjunctures, the pendulum swings in the opposite direction, and health is considered a condition for development and social cohesion, with an emphasis on building networks coordinated by PHC in order to guarantee the systems’ sustainability. The article by Lígia Giovanella & Klaus Stegmüller (p. 2263-81) updates this discussion. In addition to describing recent containment measures, the study consistently analyzes their effects. There are many similarities with the post-welfare agenda measures applied from 1980 to the mid-1990s: budget cuts with restrictions on services, increases in copayments, cost transfers to users, diminishing state responsibility, and increases in various forms of privatization. This discourse had a harmful influence on reforms in Latin America, where (unlike the central countries) there was a strong cutback in public spending. The drop in these expenditures during economic crises and fiscal adjustments has been well-documented in Latin America (Sojo A. Ciênc Saúde Coletiva 2011; 16:2673-85). Public financing was particularly vulnerable in 1994-1998 and 2001-2003, with a negative annual variation greater than the drop in the region’s GDP. Although public spending in health remains low, it has shown an upward trend, although associated with high out-of-pocket spending by families. The current European context has still not witnessed any decrease in public spending, but the study suggested that such cuts may be expected in England and Spain due to legal restrictions. Since enactment of Royal Decree Law no. 16/2012, access to the Sistema Nacional de Salud (SNS) in Spain requires coverage by the social security system, and is no longer a universal citizen’s right. There has also been growing pressure to include forms of privatization in national systems that are considered macro-efficient, as in the case of Spain. To what extent can a recessive context and increased regulation in these countries lead to market expansion in Latin America? The dynamic of accumulation in the health sector is intense, with complementary gains among the medical-industrial and medical-financial segments and major hypertrophy of services (consultancies, information technologies, exportation of hospitals, and medical tourism). Estimates for the coming years by private consultancy firms such as IMS Health and Deloitte have identified Asia, Africa, and Latin America as the most promising health care growth markets. A cutback in resources affects quality and threatens the social legitimacy of national systems oriented by PHC, such as the Spanish SNS and the UK National Health Service (NHS). The same trend has occurred in the Portuguese national health system. This risk involves the loss not only of sources of evidence, but also important references for solidarity, public administration, and health practices. This scenario, combined with the current discourse proposing “universal health coverage” in medium and low-income countries, should be analyzed with care. Without a broad discussion on models for health care practices in the health systems, the proposal may represent more of a business opportunity than timely access to health care.