Policy without politics: the limits of social engineering.
The extent of coverage provided by a country's health services is directly related to the level of development of that country's democratic process (and its power relations). The United States is the only developed country whose government does not guarantee access to health care for its citizens. It is also the developed country with the least representative and most insufficient democratic institutions, owing to the constitutional framework of the political system, the privatization of the electoral process, and the enormous power of corporate interests in both the media and the political process. As international experience shows, without a strong labor-based movement willing to be radical in its protests, a universal health care program will never be accepted by the US establishment.
Navarro
Vicente
V
Department of Health and Public Policy, Johns Hopkins University, Baltimore, Md 21205, USA. vnavarro@jhsph.edu
D030861:Capitalism; D003709:Democracy; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D006801:Humans; D007750:Labor Unions; D009310:National Health Insurance, United States / Q000331:legislation & jurisprudence*; D011057:Politics; D011209:Power, Psychological; D011332:Privatization; D012922:Social Change; D012923:Social Class; D011049:Social Control Policies; D014481:United States