Commercialisation, inequality and the limits to transition in health care: a Polanyian framework for policy analysis
2006; Wiley; Volume: 18; Issue: 3 Linguagem: Inglês
10.1002/jid.1290
ISSN1099-1328
Autores Tópico(s)Health Systems, Economic Evaluations, Quality of Life
ResumoJournal of International DevelopmentVolume 18, Issue 3 p. 393-406 Policy Arena Commercialisation, inequality and the limits to transition in health care: a Polanyian framework for policy analysis Maureen Mackintosh, Corresponding Author Maureen Mackintosh m.m.mackintosh@open.ac.uk Faculty of Social Sciences, The Open University, Walton Hall, Milton Keynes, UKProfessor of Economics, Faculty of Social Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK.Search for more papers by this author Maureen Mackintosh, Corresponding Author Maureen Mackintosh m.m.mackintosh@open.ac.uk Faculty of Social Sciences, The Open University, Walton Hall, Milton Keynes, UKProfessor of Economics, Faculty of Social Sciences, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK.Search for more papers by this author First published: 22 March 2006 https://doi.org/10.1002/jid.1290Citations: 9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract The effects of commercialised health care in embedding, exacerbating and legitimating social and economic inequality are at the root of widespread and recurrent resistance to commercialisation in health. In low income developing countries suffering generalised poverty, and notably in Sub-Saharan Africa, liberalisation of largely unregulated clinical provision has created a substantially informalised, fee-for-service primary health sector which is exclusionary, low quality and under stress. This article argues against a policy assumption that health systems constitute a sector that can benefit like other commodities from liberalisation. Health care is better understood as a 'fictional commodity' in the Polanyian sense: inappropriate for full commodification, producing intensely perverse effects when provided on competitive markets, and therefore requiring planning and social constraint. If managed effectively, integrated health systems—like redistributive land reform and effective labour protection—can support a broader economic transition that avoids extremes of inequality; conversely if treated simply as a transitional sector, health systems can make exclusion and inequality much worse. Copyright © 2006 John Wiley & Sons, Ltd. Citing Literature Volume18, Issue3April 2006Pages 393-406 RelatedInformation
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