The welfare state is flowering in Asia. Will it free the continent from squalor? Or sink it in debt?

A CARTOON cat decorates the T-shirt worn by Agus Kurniawan, a two-year-old cradled in his mother’s lap. But the cat is hard to see, because young Agus cannot hold himself upright. His body is bowed by microcephaly, an undersized skull and brain, which plays havoc with his motor functions.

His mother has been advised to seek therapy in Bandung, 60km (37 miles) away from their home in Gunturmekar, a village in the Indonesian province of West Java. The family’s medical bills there would in principle be paid by the government under a scheme called Jamkesmas, which has covered over 76m of Indonesia’s poorer citizens since 2008.

But his mother says she cannot afford to make the trips. Her hopes now rest with another scheme called PNPM Generasi. It gives funds to the village (about 47m rupiah, or $5,300 last year) which a board of 11 villagers decides how to spend. But it is doubtful Agus will qualify. PNPM Generasi is dedicated to improving school attendance, maternal health and infant nutrition. But feeding is not Agus’s problem, his mother admits. He’ll eat anything.

For decades Indonesia’s government has tried to improve the lot of villages like Gunturmekar through piecemeal projects. Some, like Jamkesmas, have breadth but no depth: it has an annual budget of less than $10 per person. Others, like PNPM Generasi, respond to the community’s demands not the individual’s. But Indonesia is now embarking on something more systematic: it is laying the foundations of a welfare state.

Last October Indonesia’s parliament passed a law pledging to provide health insurance to all of the country’s 240m citizens from January 1st 2014. One government agency will collect premiums and foot the bills, making it the biggest single-payer system in the world, says Dr Hasbullah Thabrany of Universitas Indonesia in Jakarta. The same law also committed the government to extend pensions, death benefits and worker-accident insurance to the nation by July 2015. The government has said little about the cost or generosity of these broader benefits. If Indonesia tried to universalise the kind of package now enjoyed by civil servants and 9m salaried employees, it would have to collect over 18% of wages to fund the scheme fully, according to calculations by Mitchell Wiener of the World Bank. Passing the law is always easier than paying for it.

Indonesia is not the only country in developing Asia rapidly expanding health insurance. In the Philippines, 85% of the population are now members of PhilHealth, the government-owned health insurer, compared with 62% in 2010. China’s rural health-insurance scheme, which in 2003 covered 3% of the eligible population, now covers 97.5%, according to official statistics. India has also extended (albeit modest) health insurance to roughly 110m people, more than twice the number of the uninsured Americans whose plight motivated Obamacare; this is, as America’s vice-president once said about his boss’s reforms, a “big fucking deal”.

This new Asian interest in social welfare goes far beyond health. Thailand, which achieved universal health care in 2001, introduced pensions for the informal sector in May 2011. China’s National Audit Office last month declared that the country’s social-security system was “basically” in place. India expanded its job-guarantee programme to every rural district in 2008, promising 100 days of minimum-wage work a year to any rural household that asks for it.

Tigers turning marsupial