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date: 23 January 2022

Abstract and Keywords

This chapter analyses the political influences that shaped reform of healthcare service provision and financing during four decades of neoliberal capitalist dominance, with its emphasis on individualism, consumerism, competitiveness, and the capitalist market in determining social needs and healthcare priorities. New financing sources and market competition, which shaped adoption of reforms, are contrasted with earlier reform efforts that were premised on the socialisation of risk and the universalisation of healthcare provision on an equitable basis for all. Transformation of state forms promoted the market and substantially weakened capacities to provide for basic needs. Controversy over these outcomes has coincided with astounding increases in global inequality, particularly since the 2008 global financial meltdown, with devastating and unequal effects on the health of populations. The chapter concludes by returning to the quest for universal health coverage by reaffirming the “Health for All” principles of social justice and solidarity within a ‘post-Washington consensus’.

Keywords: primary healthcare, Health for All, health sector reform, market forces, cost-effectiveness, neoliberalism, universal health coverage

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