The effects of neoliberal policies on access to healthcare for people with disabilities

Abstract

Neoliberal reforms lead to deep changes in healthcare systems around the world, on account of their emphasis on free market rather than the right to health. People with disabilities can be particularly disadvantaged by such reforms, due to their increased healthcare needs and lower socioeconomic status. In this article, we analyse the impacts of neoliberal reforms on access to healthcare for disabled people. This article is based on a critical analytical review of the literature and on two case studies, Chile and Greece. Chile was among the first countries to introduce neoliberal reforms in the health sector, which led to health inequalities and stratification of healthcare services. Greece is one of the most recent examples of countries that have carried out extensive changes in healthcare, which have resulted in a deterioration of the quality of healthcare services. Through a review of the policies performed in these two countries, we propose that the pathways that affect access to healthcare for disabled people include: a) Policies directly or indirectly targeting healthcare, affecting the entire population, including disabled people; and b) Policies affecting socioeconomic determinants, directly or indirectly targeting disabled people, and indirectly impacting access to healthcare. The power differentials produced through neoliberal policies that focus on economic rather than human rights indicators, can lead to a category of disempowered people, whose health needs are subordinated to the markets. The effects of this range from catastrophic out-of-pocket payments to compromised access to healthcare. Neoliberal reforms can be seen as a form of structural violence, disproportionately affecting the most vulnerable parts of the population – such as people with disabilities – and curtailing access to basic rights, such as healthcare.

Business Model Transformation – Challenges for the Management of the Health Care Entity

“…The significance of the determinants depends on the characteristics of the operation of each specific health care market. Clearly, at the very top of external determinants, there is a state healthcare policy that creates a specific framework for the functioning of healthcare entities (Horgan et al, 2018;Sakellariou and Rotarou, 2017), as well as a closely related policy of financing healthcare services from public funds (Ataguba et al, 2018;McCoy et al, 2017;Yates, 2015). The place of service provision is equally important, which determines the availability of resources and their costs, as well as in some cases the demand for healthcare services (Guagliardo et al, 2004;Marino and Quattrone, 2018).…”

From Criminalisation to Individual Choice: Policy Responses to Changing Constructions of Intellectual Disability in Western Australia

“…Policy implementation was influenced by the discourse of neoliberal ideology, which shaped the politics of Australia and other Anglophone countries from the 1980s. Economic policies drove social policy and resulted in a market-driven approach for goods and services, often resulting in lower quality services for people with disability (Sakellariou & Rotarou 2017) for which users were charged. One rationale for market-driven services was that it would benefit service users because they would have more choice.…”

“…One rationale for market-driven services was that it would benefit service users because they would have more choice. The same policy stated that users ought to pay for services, and this had adverse consequences for some people with ID who were no longer assured housing, support or health services (if they could not pay), which increased barriers to service access (Sakellariou & Rotarou 2017).…”

Maternal Health Care Seeking Behavior of Peri-Urban Women With Disability in Busiro South, Wakiso District, Uganda: a Community Based Study

“…These factors are main barrier to accessing sexual and reproductive health services, and may portend global efforts to achieve SDG-5 [7]. Further, the need for some persons with disabilities to have someone accompany them on the health visit not only increases transportation costs, but also raises issues of con dentiality [8,9].…”