Neoliberalism and Health: The Linkages and the Dangers

Schrecker, Ted

doi:10.1111/soc4.12408

Cited by 64 publications

(42 citation statements)

References 118 publications

(110 reference statements)

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“…The broader issue in evaluating the health effects of structural adjustment concerns the use of appropriate counterfactuals (Schrecker, 2016). In other words, what benchmark should analysts use to judge these effects?…”

Section: Resultsmentioning

confidence: 99%

Structural adjustment and health: A conceptual framework and evidence on pathways

Kentikelenis

2017

Social Science & Medicine

110

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Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies.

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Section: Resultsmentioning

confidence: 99%

Structural adjustment and health: A conceptual framework and evidence on pathways

Kentikelenis

2017

Social Science & Medicine

110

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“…There are good reasons to be critical of this discourse of empowerment, however. Drawing on critiques of privatization of health care encouraged by neoliberal discourses and policies [ 12 , 13 ], the medical tourism literature has demonstrated how industry stakeholders have taken up neoliberal assumptions about the role of market-driven care in driving economic development and enhancing patient access to care to push forward an overly simplistic discourse of empowerment in medical tourism [ 14 , 15 ]. For example, the alternative care options promoted in the media and industry sources of information are mostly taken up by patients from the global north and only those who are able to travel and pay for care, limiting this empowerment to a particular population which does not include the most vulnerable patients struggling to access care [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A critical examination of empowerment discourse in medical tourism: the case of the dental tourism industry in Los Algodones, Mexico

et al. 2018

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BackgroundMedical tourism is a term used to describe the phenomenon of individuals intentionally traveling across national borders to privately purchase medical care. The medical tourism industry has been portrayed in the media as an “escape valve” providing alternative care options as a result of vast economic asymmetries between the global north and global south and the flexible regulatory environment in which care is provided to medical tourists. Discourse suggesting the medical tourism industry necessarily enhances access to medical care has been employed by industry stakeholders to promote continued expansion of the industry; however, it remains unknown how this discourse informs industry practices on the ground. Using case study methodology, this research examines the perspectives and experiences of industry stakeholders working and living in a dental tourism industry site in northern Mexico to develop a better understanding of the ways in which common discourses of the industry are taken up or resisted by various industry stakeholders and the possible implications of these practices on health equity.ResultsInterview discussions with a range of industry stakeholders suggest that care provision in this particular location enables international patients to access high quality dental care at more affordable prices than typically available in their home countries. However, interview participants also raised concerns about the quality of care provided to medical tourists and poor access to needed care amongst local populations. These concerns disrupt discourses about the positive health impacts of the industry commonly circulated by industry stakeholders positioned to profit from these unjust industry practices.ConclusionsWe argue in this paper that elite industry stakeholders in our case site took up discourses of medical tourism as enhancing access to care in ways that mask health equity concerns for the industry and justify particular industry activities despite health equity concerns for these practices. This research provides new insight into the ways in which the medical tourism industry raises ethical concern and the structures of power informing unethical practices.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0392-3) contains supplementary material, which is available to authorized users.

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“…Ideas, when embedded, and constructed for example as new rules or norms, can also form new institutions [ 46 , 49 ]. While equity has been refined and developed as an idea and achieved greater profile through the WHO Commission on the Social Determinants of Health [ 1 ] and subsequent reviews and debate, it has been challenging for the ideas of equity and reducing inequalities to become embedded as a new institution because of the institutional dominance of the entrenched neo-liberal ideas of the free market, privatization of public goods, individuals as consumers rather than citizens, and reduced state intervention, amongst others [ 50 , 51 ].…”

Section: Methodsmentioning

confidence: 99%

Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective?

Eyk

Harris

Baum

et al. 2017

IJERPH

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Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health to improve population wellbeing and reduce health inequities. This paper presents selected findings from a five year multi-methods research study of the SA HiAP approach and draws on data collected during interviews, observation, case studies, and document analysis. The analysis shows that SA HiAP had dual goals of facilitating joined-up government for co-benefits (process focus); and addressing social determinants of health and inequities through cross-sectoral policy activity (outcomes focus). Government agencies readily understood HiAP as providing tools for improving the process of intersectoral policy development, while the more distal outcome-focused intent of improving equity was not well understood and gained less traction. While some early rhetorical support existed for progressing an equity agenda through SA HiAP, subsequent economic pressures resulted in the government narrowing its priorities to economic goals. The paper concludes that SA HiAP’s initial intentions to address equity were only partially enacted and little was done to reduce inequities. Emerging opportunities in SA, and internationally, including the UN Sustainable Development Goals, may revive interest in addressing equity.

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Neoliberalism and Health: The Linkages and the Dangers

Cited by 64 publications

References 118 publications

Structural adjustment and health: A conceptual framework and evidence on pathways

Structural adjustment and health: A conceptual framework and evidence on pathways

A critical examination of empowerment discourse in medical tourism: the case of the dental tourism industry in Los Algodones, Mexico

Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective?

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