Neo-liberal political-economic ideology, theory and practice have had an immense influence on public and private life across the world, including the delivery of health care, and neo-liberalism has become the dominant economic paradigm. Market practices, business management theories and practices, and private enterprise have become increasingly significant in health care, as the welfare state and public health services have been challenged by factors such as rising costs, economic efficiency, globalisation and increasing competitive demands. The question of how, and to what extent, neo-liberalism has influenced contemporary health care is, however, deserving of more critical attention. This thesis examines the neo-liberal approach to, and effect on, contemporary health care, in the context of Western developed countries, and offers a conceptual analysis of the theoretical and ideological framework of neo-liberalism, especially regarding its ethical and moral underpinnings. Additionally, this thesis is concerned with the moral nature of health care. The objectives of this thesis are to articulate and analyse the neo-liberal interpretive framework, moral values and language; and to articulate and analyse the neo-liberal approach to, and effect on, contemporary health care. Thus, it is the intention that this thesis will provide a framework for reflection on the context of contemporary health care in Western developed countries and the influence of neo-liberalism. To achieve these objectives, the research strategy of this thesis is that of philosophical inquiry, additionally drawing on political philosophy; and the research is, therefore, basic, theoretical research. This thesis finds that neo-liberalism, and the neo-liberal approach to health care, is a highly complex theory and ideology, constituted of several intricate concepts and moral underpinnings. It is found that the neo-liberal approach affects the nature and purpose of health care, for example by making health care part of the free, competitive market, by commodifying health care, and by replacing the notions of the common good, social justice and public health care with an emphasis on the rational, self-interested consumer, individual responsibility and self-sufficiency. Another essential aspect of the neo-liberal approach is that it emphasises the ability to pay (user-pays system), rather than health care need, as the dominant determinant in health care. Furthermore, this thesis finds that the neo-liberal ideology excludes the ontological complexity and reality of the human condition, and in health care this has consequences in relation to, for example, interdependency, interrelationships, vulnerability and need. In essence, this thesis finds that there are several pragmatic and moral problems with applying a neo-liberal approach to health care, and that the complexities, irregularities, and unpredictability of health care make a neo-liberal approach difficult to realise in health care. The neo-liberal approach undermines the moral purposes of health care, and it is concluded that the neo-liberal approach offers no well-founded moral alternative to the universalistic, solidarity based approach common in most Western developed countries (except in the United States). This thesis seeks to add to the knowledge and literature concerning neo-liberalism, especially as regards its moral underpinnings and normative framework, and, furthermore, concerning the neo-liberal approach to, and effect on, contemporary health care in Western developed countries. Additionally, this thesis seeks to contribute to the knowledge of philosophical inquiry by documenting the method of 'doing' philosophical inquiry. Based on the research in this thesis, it is clear that there is a need for more empirical research into the pragmatic consequences of applying neo-liberal policies and practices to health care, and the analysis in this thesis could favorably serve as a basis for empirical inquiry.
| Identifer | oai:union.ndltd.org:ADTP/265629 |
| Date | January 2007 |
| Creators | Ruthjersen, Anne Linda |
| Publisher | Queensland University of Technology |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
| Rights | Copyright Anne Linda Ruthjersen |
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