SOC309Y1- AIDS, Neoliberalism & Responsibility: A New Moral Panic
HIV/AIDS: Social Policies and Programs
1980s first moral panic that moralism was part of religious forms of moralism and condemnation
(same sex and less accepting society) and a moralism creeping into public discourse with the idea we
are solely responsible for our health as individuals.
What shapes how we think about health? (2 key things)
o And the way it is entrenched in our society, not so much in US, Canada is more
individualistic than great social welfare states of Scandinavian countries
o Creeps up in everything we do and think about our health
o Moral ways of looking at smokers, eating food presumed not good for you then the
guilt number you do on yourself that creeps out of an individualistic notion of
responsibility for our health. We used to think differently of what good health was. N
and L go hand in hand.
Neoliberalism refers to a historically-specific reemergence of economic liberalisms influence
among economic scholars and policy-makers from the 1970s. The 70s were a time of 30 years
of building of great welfare state (45, later war ending 2 total wars, housing/health care
boom, national medi-care program, boom in Canadian economy) Most people were middle
class, good paying service jobs that now today pay minimum wage did not exist back then.
Our government was manufacturing which transformed to IT and health (knowledge based
economy) Globalization accompanied neoliberalism
- Neoliberalism is characterized by: (6 key points)
o Market dominance free enterprise, the private world of capital and business
o Small government (non-interventionist)- more efficient to privatize healthcare like US?
24% of every dollar spent for administrative cost
o Tax reform- tax cuts will create jobs? No there is no utter proof. Only working class
people apparently stimulate the economy by spending all money they have.
Health and social program cuts suffered the most
Tax cuts reduce government purse to pay for services o Trade liberalization
o Deregulation of industry
o Health/social program cuts
- Responsibility placed on individual and family- moved from the state!
- Smoking, diet and exercise are the 3 things we obsess about it our society. Can argue that not
having poverty makes a society far healthier!
- Another key thing behind neoliberalism= That societies are composed of autonomous
individuals (producers and consumers) motivated chiefly or entirely by material or economic
considerations- the notion we will play in the market to contribute to the health of the nation
4 Outcomes of Neoliberalism
1. Increased emphasis on encouraging labour market participation
o 2009 data the last decile has become huge and filthy wish, the last one has turned into
30% and the middle has dipped (middle dipped)
o = poor bigger percentage, middle disappearing, rich getting richer = SIMILAR TO THE UK
large poor working class and small proportion of rich
2. A shift away from concepts of universality towards providing targeted benefits to populations
designated as being low-income
o Not everyone in neoliberal state is eligible for social welfare like we used to be
o One time people used to get unemployment insurance more easily, welfare is more
difficult to get now (CANADIAN WELFARE $571/month for single person- no credit
cards- no savings account neoliberalism has put tight reigns on people to make
poverty a self-fulfilling prophecy)
3. A downloading of the responsibility for the maintenance of social cohesion from the society to
the individual (McKeen & Porter, 2003).
o There used to be a different perception- people did not complain about tax cuts in the
past- they believed great services were provided (healthcare)
o Warren Buffet said congress is too friendly to billionaires where rich allowed to
accumulate so much and all else suffer neoliberalism put great pressure on individuals
o Worst neoliberal government 1995 Mike Harris Conservative government- common
sense revolution policy- actually there was nothing sensible about it, the ycut social
welfare rates 22% o These things have impact on society!
4. This places an astonishing amount of pressure on individuals and families.
Individualism is the moral stance, political philosophy, or social outlook that stresses
independence, self-reliance and individual liberty. Individualists promote the exercise of
one's goals and desires, while opposing most external interference (government) with
one's choices, whether by society, the state, or any other group or institution.
- Individualism has played out in an interesting way in America since 1994 (Clinton)
appointed wife as health care advisor to introduce comparable private health care. US
private for profit, hospitals are businesses, corporations, business of making money
while delivering health care- this is odd to Canadians
- In the US- Hilary Clinton failed, backlash so intense, no way to allow government funded
socialized medical system
- Obama might have more luck with insurance introduced
- Costs $5600/year for Canadian health care- 1200 per month in US compare that to
high Canadian tax argument!
- Individualism creped into US health care debate by using terms like product seeing
healthcare as a consumer choice- we will sell you a product to protect your family
Instead Canada sees it as a human right to have access to healthcare
- US= great neo-liberal nation, taken things to the most extreme, different form of neo-
liberalism more likely to be called neo-conservatism
- Neo-liberal shift left to privatization of health concerns The old was worried about
sanitation and germs, by 60s identification of germs and notion we become sick because
of things that cause us to be ill, behavioral risk factors 80s HIV moved from us to our
BEHAVIORS which fit well in neo-liberal framework
society is no longer the field of operation for the state (i.e., people responsible for
retraction of welfare state
disease and health concerns privatized
This neoliberal shift then has led to the privatization of disease concerns.
self-reliance- not to rely on state too much responsible for self
...this (the welfare state) has been eclipsed by a more individualistic approach whose rhetoric
speaks of the individual's responsibility to the self through healthy lifestyle choices. (Dodds, p.
140) we have ended up thinking that what we do, eat, exercise, - those things are what make us
healthy or sick- this is the impact neo-liberalism has had- AIDS emerged into all of this discourse,
high culpability disease (linked to unprotected sex with highly stigmatized people) linked to
injection drug use, etc. so the rhetoric highly moralized from religious point of view blamed people
for their individual action of say not using a condom- thus those infected tend to blame selves.
- We know from years of evidence, social factors like poverty and inequality, make people sick!
Exercising on the other hand may make us healthier
- Example: every 1000 new cases of diabetes, every 1000 new cases of smoking, 1000 new HIV
etc. you will see if you do a scatter plot you will see a disproportionately high amount of poor
people thus health is taken away, not individual behaviours
- Neo-liberal state made this get even worse deep forms of poverty are the worse outcome of
HIV is the first disease to arrive in neo-liberal milieu
affects already stigmatized groups in society
acquired in ways that suggest behavioral culpability or responsibility
high moral valence attached to the disease
external and internal blame
The creation of risk groups (and their corollary behaviours) allowed for the moralization of disease and
the moralization of health behaviours
Deborah Lupton talks about the New Public Health one driven by epidemiological data
related to risk and behavioural risk reduction
The old public health dealt with poverty, sanitation, and ensuring people had shelter, food and
Sarah Nettleton talks about the holy trinity of the modern public health movement
- exercise, diet and smoking
Responsibility Discourse and HIV
- At core of neoliberalism is individualism- individualism is at the core!
- Idea that responsibility is central and essential of all health campaign in the world