Is it too late to turn back the clock of managerialism and neoliberalism?

Abstract

The esteemed health economist, Gavin Mooney, who died in tragic circumstances in December 2012, devoted his last book The Health of Nations: Towards a New Political Economy[1] to exposing the pernicious effects of neoliberalism on healthcare. He argued compellingly that the consequences of ‘neoliberalism’ – in his usage, the reliance on market mechanisms to address all the needs of a society in the areas of healthcare, education, social welfare and even the arts – have been disastrous for the health system and have exacerbated inequalities in access to care at both the national and global levels. They have led to inappropriate and perverse social outcomes, distorted the kinds of medicines and technologies that are employed, increased the equity gap, and exacerbated environmental destruction. He posed the question of whether it is possible to reverse what has, until now, been largely assumed to be an inexorable trend and, using case studies drawn from both developed and developing countries, drew attention to several possible alternative strategies for designing and delivering the sort of healthcare that may enrich communities, increase equity and properly address the social determinants of health.