Health reforms in Latin America: processes and results

Two types of health reforms in Latin America are analysed: one based on insurance and service commodification and the one referred to the unified public systems of progressive governments. Health insurance with explicit service packages has not fulfilled their purposes of universal coverage, equal access to necessary health services and improvement of health conditions but has opened health as a field of profit making for insurance companies and private health providers. The national health services as a state obligation have developed territorialized health services and widened substantially timely access to the majority of the population. The adoption of an integrated and wide social policy has an impact on population well fare. It faces some problems derived from the old health systems and the power of the insurance and medical complex.

Neoliberalism as an ideology

In order to examine whether the usual identification of neoliberal ideas with an ideological discourse is valid, this paper starts off with an analysis of what Marx terms commodity fetishism in Capital, based on which a certain sense of the concept of ideology may be inferred which would result in its being both true and false. In order to determine whether this definition of ideology may be applied to neoliberal theory, we look at its fundamental features and how they continue with or break away from economic liberalism as studied in Michel Foucault’s Birth of biopolitics. Attention is later moved to the characteristics detected by David Harvey in the socalled flexible accumulation as the latest stage of capitalism which coincides with the political implementation of neoliberal doctrine. At the end of the road travelled, it is hypothesised that this theory would be a form of ideology containing a dimension of both truth and falsehood, in line with Marx’s thought.