Debating the comprehensive basis of Western healthcare systems in the light of neo-liberalism

Abstract

The wide range of literature on the subject of healthcare reforms makes it difficult to clearly identify some of their main implications. We therefore try to further the debate with this introductory paper which aims to highlight the argument of the individual-oriented nature of health policies nowadays. It specifically refers to the consequences of the current neo-liberal context for public intervention in countries where health policies were originally collective-oriented with a view to comprehensive coverage. Following this analytical discussion, we scrutinize some empirical data gathered from the 2011 OECD Health Data that are particularly relevant to this issue. Although different patterns are found in western countries, there is evidence that users cannot rely solely on tax and insurance when accessing health services but increasingly have to use their own sources of finance. This is in total contradiction with the ideological basis underpinning public policies that called on states to intervene for a more equal society. Given that the best financial solution is not necessarily in the users’ best interest, it is important to analyse the extent to which efficiency is replacing equity.