Between marketisation and public interest discourses in health policy delivery

This chapter illustrates how policymaking processes about seemingly technical questions also involve debates about broader philosophical questions concerning the boundaries and purposes of political communities. More specifcally, I show that reverting to market logics to settle political questions is problematic. It encourages a focus on technical issues rather than fundamental questions about the forms of collective well-being political communities pursue. In this way, policymaking can obscure or avoid engaging in debating a central political question: who should get what, when and why? In health policy, addressing this question entails a public and critical engagement with three fundamental questions: what kinds of social relations are created by market-based strategies to improve collective and individual well-being? What vision of the “good life” is implicit in these strategies? Is this vision of the good life consistent with the idea that all citizens should enjoy full and equal participation in the community’s social, cultural and political life (Marshall 1964)? These questions are simply elided by presuming that for-proft market mechanisms are the “best” or are “un-avoidable” mechanisms for promoting public health.

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Published in: Routledge Handbook of Public Policy in Africa
License: http://creativecommons.org/licenses/by-nc-nd/4.0
See article on publisher's website: https://dx.doi.org/10.4324/9781003143840-46