Universal health coverage and capital accumulation: a relationship unveiled by the critical political economy approach

• Published in: International journal of public health Vol. 65; no. 7; pp. 995 - 1001
• Main Authors: Hernández-Álvarez, Mario, Eslava-Castañeda, Juan Carlos, Henao-Kaffure, Liliana, Orozco-Díaz, José, Parra-Salas, Luis Edgar
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2020; Springer Nature B.V
• Subjects: Capitalism; Delivery of Health Care - economics; Delivery of Health Care - history; Delivery of Health Care - legislation & jurisprudence; Delivery of Health Care - statistics & numerical data; Environmental Health; Global Health - economics; Global Health - history; Global Health - legislation & jurisprudence; Global Health - statistics & numerical data; Health Services - economics; Health Services - history; Health Services - legislation & jurisprudence; Health Services - statistics & numerical data; History, 20th Century; History, 21st Century; Humans; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Original Article; Politics; Public Health; Universal Health Insurance - economics; Universal Health Insurance - history; Universal Health Insurance - legislation & jurisprudence; Universal Health Insurance - statistics & numerical data; Healthcare financialization; Healthcare systems; Medical–industrial complex; Universal health coverage; Cognitive capitalism; Global health agenda
• ISSN: 1661-8556; 1661-8564
• DOI: 10.1007/s00038-020-01437-9

Objectives To analyze the fundamentals of the global health agenda from 1944 to 2018, especially regarding Universal Health Coverage, in order to unveil its relations with capital accumulation in health services and to contribute to world social mobilization to change this tendency. Methods A historical study was carried out based on a purposeful selection of primary sources on the global health agenda from multilateral organizations and secondary sources about the changes of capitalism from the study period. Results The global health agenda changed from the state responsibility for health to an insurance healthcare system based on markets. The medical–industrial complex pressured national economies, broke postwar pacts, and urged economic globalization. The neoliberal, neoclassical, and neo-institutional discourse that promoted a new state–market relationship eased the new capital accumulation in healthcare into financial and cognitive capitalism. Conclusions Understanding these relationships allows us to provide elements for social mobilization geared to transform the healthcare sector toward a new vision of health with a nature–society relationship that contributes to socially constructing human and environmental health, rather than gaining profits based on illness and chronic suffering.