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.

Incertidumbre y actitudes pro-redistributivas: mercados de trabajo y modelos de bienestar en Europa

La articulación entre las políticas de empleo y las políticas sociales condicionan la percepción subjetiva de incertidumbre los individuos. El modelo de mercado laboral tiene un peso determinante en la percepción de incertidumbre. El empleo en sí mismo ya no es suficiente garantía de ingresos seguros. El empleo a tiempo parcial y los contratos temporales generan una creciente demanda de políticas de redistribución de los ingresos en los países del Sur y Este de Europa. En los países escandinavos los mismos tipos de contratos laborales generan menos desigualdad porque el empleo público contribuye a generar un “círculo virtuoso” que favorece las políticas de igualdad y la conciliación entre la vida laboral y familiar. A nivel individual las actitudes pro-redistributivas las impulsan las mujeres, aquellas personas con incertidumbre en sus ingresos económicos y con bajo nivel de estudios. Por el contrario, quienes más confían en el éxito individual y el mérito son los jóvenes con estudios universitarios y aquellos que perciben ingresos económicos altos.

Rethinking Care Through Social Reproduction: Articulating Circuits of Migration

Care has come to dominate much feminist research on globalized migrations and the transfer of labor from the South to the North, while the older concept of reproduction had been pushed into the background but is now becoming the subject of debates on the commodification of care in the household and changes in welfare state policies. This article argues that we could achieve a better understanding of the different modalities and trajectories of care in the reproduction of individuals, families, and communities, both of migrant and nonmigrant populations by articulating the diverse circuits of migration, in particular that of labor and the family. In doing this, I go back to the earlier North American writing on racialized minorities and migrants and stratified social reproduction. I also explore insights from current Asian studies of gendered circuits of migration connecting labor and marriage migrations as well as the notion of global householding that highlights the gender politics of social reproduction operating within and beyond households in institutional and welfare architectures. In contrast to Asia, there has relatively been little exploration in European studies of the articulation of labor and family migrations through the lens of social reproduction. However, connecting the different types of migration enables us to achieve a more complex understanding of care trajectories and their contribution to social reproduction.