Abstract
In the broadest sense, the field of the political economy of health examines relationships between socio-economic systems and healthcare performances. A nation’s healthcare system (capitalist-cum-neoliberal, socialist-cum-socialized, or two-tier) has profound implications for the health indicators of any nation. The argument is also in line with the social production of health and illness. Socialist-cum-socialized or capitalist-cum-neoliberal healthcare systems provide a good comparative terrain for those interested in the social production of health, as both types have strengths and weaknesses. In reality, almost no country has a pure socialist or a pure capitalist healthcare system; most systems are mixed, with one type predominant over the other. The debate is still on-going as to which form of healthcare guarantees the best care for the general populations worldwide. Most African countries tend to practice a two-tier health care system, a mix of both public and private provisions of healthcare. The critical question is which healthcare system works best and why. This chapter introduces the readers to the three major patterns of healthcare systems (capitalist-cum-neoliberal, socialist-cum-socialized and mixed systems), describing their strengths and weaknesses.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ackerly, D. C., Valvered, A. M., Diener, L. W., Dossary, K. L., Schulman, K. A. (2008). Fueling innovation in medical devices (and beyond): venture capital in health care. Health Affairs, 28(1), w68–w75.
Amzat, J. (2011). Assessing the progress of malaria control in Nigeria. World Health and Population, 12(3), 42–51.
Bjerk, P. K. (2010). Sovereignty and socialism in Tanzania: the historiography of an African State. History in Africa, 37, 275–319.
Breyer, F., & Kliemt, H. (2015). “Priority of Liberty” and the design of a two-tier health care system. Journal of Medicine and Philosophy, 40(2), 137–151. doi:10.1093/jmp/jhu076.
Buchanan, A. E. (1987). The profit motive in medicine. Journal of Medicine and Philosophy, 12(1), 1–35.
Cappelen, A. W., & Norheim, O. F. (2005). Responsibility in health care: a liberal egalitarian approach. Journal of Medical Ethics, 31, 476–480.
Conrad, P. (2005). The shifting engines of medicalization. Journal of Health and Social Behavior, 46, 3–14.
Ghoshal, R. (2015). What ails India’s two-tiered healthcare system? A philosophical enquiry. Indian Journal of Medical Ethics, 12(1), 25–29.
Hartwich, O. M. (2009). Neoliberalism: the genesis of a political swearword. CIS Occasional Paper 114, Centre for Independent Studies. Sydney, New South Wales.
Illich, I. (1975). The medicalization of life. Journal of Medical Ethics, 1, 73–77.
Kennedy, P. (2015). The contradictions of capitalist healthcare system. Critique: Journal of Socialist Theory, 43(2), 211–231.
KPMG-Africa (2012). The state of healthcare in Africa. Johannesburg, South Africa.
Krohmal, B. J., & Emanuel, E. J. (2009). Tiers without tears: the ethics of a two-tier health care system. In B. Steinbock (Ed.). The Oxford handbook of bioethics. Oxford: Oxford University Press.
Lehoux, P., Miller, F. A., Daudelin, G., Urbach, D. R. (2016). How venture capitalists decide which new medical technologies come to exist. Science and Public Policy, 43(3), 375–385. doi:10.1093/scipol/scv051.
Loewy, E. H. (1997). What would a socialist health care system look like? A sketch. Health Care Analysis, 5, 3195–204.
Rowe, K., & Moodley, K. (2013). Patients as consumers of health care in South Africa: the ethical and legal implications. BMC Medical Ethics, 14, 15. doi:10.1186/1472-6939-14-15.
Rylko-Bauer, B., & Farmer, P. (2002). Managed care or managed inequality? A call for critiques of market-based medicine. Medical Anthropology Quarterly, 16(4), 476–502.
Sachs, B. (2008). The liberty principle and universal healthcare. Kennedy Institute of Ethics Journal, 18(2), 149–172.
Scott, B. R. (2006). The political economy of capitalism. Harvard Business School, Harvard Working Paper, www.hbs.edu/faculty/Publication%20Files/07-037.pdf. Accessed 4 May 2016.
Smith, E. R. (2007). A two-tier healthcare system: is there anything new? Canadian Journal of Cardiology, 23(11), 915–916.
Waitzkin, H. (1981). A marxist analysis of the healthcare systems of advanced capitalist societies. In L. Eisenberg, A. Kleinman (Eds.). The relevance of social science for medicine (pp. 333–369). Dordrecht: Springer.
Author information
Authors and Affiliations
Corresponding authors
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Amzat, J., Razum, O. (2018). Healthcare Delivery Systems. In: Towards a Sociology of Health Discourse in Africa. Springer, Cham. https://doi.org/10.1007/978-3-319-61672-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-61672-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-61671-1
Online ISBN: 978-3-319-61672-8
eBook Packages: Social SciencesSocial Sciences (R0)