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Health Sciences 1002A/B Neoliberalism and Political Economy.docx

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Western University
Health Sciences
Health Sciences 1002A/B
Jessica Polzer

1002A Health Science Neoliberalism as a Barrier to Equity and Health / The Political Economy of Health October 2 and October 4, 2012 Theories of Social Inequality & Exclusion • Rooted in theories of Marx, Weber (and others) • Asks questions like:  How is society organized or structured?  How do social structures distribute power and resources in ways that create social inequalities (and therefore health inequalities)? • Social Structure – ideas that things are not directly observable Marx on Social Inequality • How are societies organized in capitalist economic systems? • Model of society included economic base and ideological superstructure • Economic relations determine social relations • Social Class – 2 conflicting classes in classical Marxist theory – bourgeoisie and proletariat  Bourgeoisie are the owners of means of economic production  The workers sell their labour to support themselves – they are in constant conflict with the Bourgeoisies Class and Social Inequality • Capitalist Economies are inherently exploitative  It means that capitalist economies are oriented towards profit  Exploitation and surplus value  Those who control the production, profit from the job of the workers. They profit from surplus value, which means what the working earns vs. what the product is marked up to. This is how exploitation works • Social inequalities derive from class relations which are rooted in economic relations Class, Social Inequality, & Poverty • Economic base > social class > social inequality > income inequalities (poverty) > health inequalities • Poverty is an outcome of social inequality • Social inequality is a structural element of capitalism • Poverty results when insufficient measures are taken to compensate for the imbalance in access to resources and opportunities Why Should We Care About This? • Morbidity and mortality patterns correspond to social class inequalities that are produced by capitalist economic systems • Also, under conditions of capitalism, health is more likely to be seen as a commodity rather than a public good Role of Ideology • Role of Ideology in perpetuating social inequality • Ideology – system of ideas that legitimizes economic base, helps sustain capitalism if you’re in a capitalist society • Owners of means of economic production are usually the owners of the means of ideological production Neoliberalism as a Barrier to Social and Health Equity • Features of neoliberalism 1. The rule of the market 2. Public Spending reduced 3. Deregulation 4. Privatization 5. Discourse of individual responsibility • It is a dominant way of thinking about how society should be governed (ex. What should health policy look like, how should social policy look like?) • Liberalism as a political rationality, took a new form in the 70’s during a time of high inflation and unemployment – stagnation 1. The Rule of the Market • The idea that market rules • Arena of society when you purchase goods and services • Any decision-making by the government should always favour economic production and growth. Even it if it has detrimental effects on social wellbeing • Both social relations down to economic relations • If you prioritize the market over citizens and their rights, your role is more important as a consumer 2. Reduced Public Spending • Any government spending on social programs like health insurance, education, and welfare is a waste of money 3. Deregulation • Deregulation of government controls  Any deregulation of government goes to ensure public safety  E.g. deregulation of water safety testing 4. Privatization • Ideas that all services provided should be private companies and not the government • Anything that is a public good should be transformed to a private market • Private systems will generate better competition which leads to better prices and more consumer choice • Private systems will generate better competition which leads to better prices and more consumer choice • The problem is that this relies on people’s ability to take pat in the market at a certain level 5. Discourse of “Individual Responsibility” • This presides over the discourse of public good or accountability; it is up t
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