A trademark of our times is the dominance of neoliberalism in the major economic, political, and social forums of the developed capitalist countries and in the international agencies they influence-including the IMF, the World Bank, the WTO, and the technical agencies of the United Nations such as the World Health Organization, Food and Agricultural Organization, and UNICEF. Starting in the United States during the Carter administration, neoliberalism expanded its influence through the Reagan administration and, in the United Kingdom, the Thatcher administration, to become an international ideology. Neoliberalism holds to a theory (though not necessarily a practice) that posits the following
The growing inequalities we are witnessing in the world today are having a very negative impact on the health and quality of life of its populations. It is true, as many conservatives and neoliberal authors continue to stress, that health indicators are improving in many parts of the world, including in many underdeveloped countries. But what these authors are not saying is that the rate of improvements in these indicators have slowed down in most countries that have experienced a growth of inequalities, and in many of them, including the United States, these indicators have even reversed. According to the last report of the National Center for Health and Vital Statistics, infant mortality in the United Staes has increased, reversing the decline that had occurred since 1953.1 The growth of inequalities is thus bad for people’s health. But why?
The health sector of the United States is in profound disarray. Even though the United States spends more on health care (14 percent of its GNP) than any other country, we still have problems that no other developed capitalist country faces. Let me list some of them. The first and most overwhelming problem is that no less than forty-four million of our people have no form of health benefits coverage whatsoever. The majority of them are working people, and their children, who cannot afford to pay the health insurance premium that would enable them to get care in time of need. Many of them work for small companies that cannot or will not pay their part of the health insurance premium. Because these individuals cannot pay for insurance, they do not get needed care, and many die as a consequence. The most credible estimate of the number of people in the United States who have died because of lack of medical care was provided by a study carried out by Professors David Himmelstein and Steffie Woolhandler (New England Journal of Medicine 336, no. 11 ). They concluded that almost 100,000 people died in the United States each year because of lack of needed care—three times the number of people who died of AIDs. It is important to note here that while the media express concern about AIDs, they remain almost silent on the topic of deaths due to lack of medical care. Any decent person should be outraged by this situation. How can we call the United States a civilized nation when it denies the basic human right of access to medical care in time of need? No other major capitalist country faces such a horrendous situation