title: The History and Future of Neoliberal Health Reform: Obamacare and Its Predecessors.
abstract: The Colombian reform of 1994, through a strange historical sequence, became a model for health reform in Latin America, Europe, and the United States. Officially, the reform aimed to improve access for the uninsured and underinsured, in collaboration with the private, for-profit insurance industry. After several historical attempts at health reform adhering to the neoliberal pattern, favored by international financial institutions and multinational insurance corporations, the Affordable Care Act (ACA) similarly enhanced access by corporations to public-sector trust funds. An ideology favoring for-profit corporations in the marketplace justified these reforms through unproven claims about the efficiency of the private sector and enhanced quality of care under principles of competition and business management. The ACA maintains this historical continuity by dealing with health care as a commodity bought and sold in a marketplace, rather than a fundamental human right to be guaranteed according to principles of social solidarity. As the ACA heads toward probable failure, a space finally will open for a U.S. national health program that does not follow same historical patterns of the neoliberal model.
authors.affiliation: Department of Sociology, University of New Mexico, Albuquerque, New Mexico, USA Department of Internal Medicine, University of Illinois, Rockford, Illinois, USA waitzkin@unm.edu.
authors.forename: Howard
authors.initials: H
authors.lastname: Waitzkin
authors.affiliation: Physicians for a National Health Program, Chicago, Illinois, USA.
authors.forename: Ida
authors.initials: I
authors.lastname: Hellander
mesh_terms: D003105:Colombia; D005544:Forecasting; D018166:Health Care Reform / Q000266:history* / Q000639:trends; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D014481:United States
keywords: Latin America; affordable care act; health policy; health reform; neoliberalism