The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

La ruptura de una economía moral y las deslegitimación de las deudas hipotecarias

In Spain, during the recent housing bubble, purchasing a home seemed the most advantageous strategy to access housing, and there was a wide social consensus about the unavoidability of mortgage indebtedness. However, such consensus has been challenged by the financial and real-estate crisis. The victims of home repossessions have been affected by the transgression of several principles, such as the fair compensation for effort and sacrifice, the prioritisation of basic needs over financial commitments, the possibility of a second chance for over-indebted people, or the State's responsibility to guarantee its citizens' livelihood. Such principles may be understood as part of a moral economy, and their transgression has resulted in the emergence of a social movement, the Plataforma de Afectados por la Hipoteca (PAH), that is questioning the legitimacy of mortgage debts. The article reflects on the extent to which the perception of over-indebtedness and evictions as unfair situations can have an effect on the reproduction of the political-economic system, insofar the latter is perceived as able or unable to repair injustice.

El razonamiento moral como elemento constitutivo de la competencia ética: dilemas reales e hipotéticos en profesores de educación secundaria en México

El objetivo del presente texto es la indagación del razonamiento moral en los profesores de secundaria como un elemento de la competencia ética. Se realizó con dilemas morales hipotéticos (analizados y probados previamente para su validación y cuya fiabilidad se obtuvo a través del alfa de Cronbach) y con dilemas reales. Se aplicó a 264 profesores, miembros de la comunidad académica de la Escuela Normal Superior de Michoacán, México. Se analizó a través del programa estadístico Aquad 6. Entre los descubrimientos se encuentra una presencia mayoritaria de conflictos entre las normas éticas interpersonales con las normas de conformidad social y con las normas institucionales particulares. También que la justicia y la protección contra daños a los alumnos son valores presentes en los dilemas reales y una prevalencia en el razonamiento convencional de los profesores