21st-century capitalism: structural challenges for universal health care
- PDF / 289,952 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 218 Views
COMMENTARY
Open Access
21st-century capitalism: structural challenges for universal health care Susan K. Sell From The Political Origins of Health Inequities and Universal Health Coverage Oslo, Norway. 01-02 November 2018
Abstract The structural perspective outlined here sheds light on some of the fundamental challenges involved in achieving Universal Health Care (UHC) in this twenty-first-century era of trade and financialized capitalism. This commentary explores connections between the structure of twenty-first-century capitalism and challenges to achieving UHC, discussing three features of today’s capitalism: financialized capitalism; trade, intangibles and global value chains; and inequality (as exacerbated by the first two features). The final section discusses the various opportunities for reform to facilitate UHC—from tinkering with the status quo, to deeper regulatory reform and fundamental structural change. Keywords: Financialized capitalism, Global supply chains, Inequality, Intellectual property
Background This commentary presents several features of twenty-firstcentury capitalism, highlighting some of the challenges it poses for achieving universal health care (UHC), or access for all to appropriate health services without financial hardship [1]. The World Health Organization, the United Nations and many civil society organizations have promoted UHC as an organizing principle for national health systems [2]. Viewed in narrow terms, UHC may be restricted to “expansion of access to health care services,” whereas broader conceptions address the social determinants of health across multiple sectors and the “public health interventions needed to effectively address noncommunicable diseases (NCDs)” ([3], p.1). Scholars agree that achieving UHC requires sufficient funding and an active public sector role to manage the shift from out-ofpocket expenditures to pooled health spending, including health insurance and prepaid schemes [4, 5]. McKee et al. note that, historically, health-care expansion has “tended to require a confluence of political opportunities, available financial resources (mainly from a functioning tax revenue base), and the mobilization of strong left political parties, Correspondence: [email protected] School of Regulation and Global Governance, The Australian National University, Acton, Australia
leaders, and representatives (including trade unions)” ([6], p.S40). While some countries have made considerable progress towards achieving UHC [1, 7], the long-standing quest to achieve UHC faces new challenges in the era of twenty-first-century capitalism. This commentary explores some of the connections between the structure of twenty-first-century capitalism and challenges to achieving UHC, focusing on three features of today’s capitalism in particular: financialized capitalism; trade, intangibles, and global value chains; and inequality (as exacerbated by the first two features). The final section discusses the various opportunities for reform to facilitate UHC—from tinkering with the s
Data Loading...
