1963-2013 - 50 years of Research for Social Change

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Back | Programme Area: Social Policy and Development (2000 - 2009)

Health Care Commercialization and the Embedding of Inequality: RUIG/UNRISD Health Project Synthesis Paper (Draft)

Health care systems can embed and reinforce inequality within societies—or, conversely, can be a platform for the public combating of poverty and inequality. The objective of this paper is to argue that the process of health care commercialisation—a marked trend across the world since the 1970s for reasons that are explored—and the associated process of globalization of both health care and health policy, changes the terms of these interactions. Commercialization—sometimes, discreditably, “sold” as a policy for increasingly equity—has generally acted to embed inequality in new forms.

This paper examines the pressures for commercialization in health care; proposes analytical categories of analysis of commercialization that can be used for empirical work; explores some available data on the extent of commercialization and examines its interaction with other aspects of inequality. It argues that health care is a key site on which the social challenge of globalization is played out: an area where commercialization has to be at least partially blocked if socially inclusive development is to be possible, and also a policy arena within which—because of the ethical importance of health care to society—that blocking is possible. The author draws on the work of Karl Polanyi on the economic and social impact of market mechanisms in “social” goods to underpin the argument that commercialization in health care is particularly destructive of social cohesion, as well as a key site for the social and political framing of more egalitarian development processes.

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