ALL AH WE IS ONE – This neoliberalism
David Comissiong must be congratulated for introducing a philosophical perspective into the ongoing debate on the delivery of health care in Barbados.
Writing in the People’s Empowerment Party (PEP) column, he isolated the Minister of Health’s uncritical conformity to neoliberal ideology as the primary explanation for the changes in the provision of health care. In contrast, other contributions, though useful, have been narrowly “technical” in nature, and have shied away from a philosophical rejection of the neoliberal assumptions which currently guide the policy.
Thus, for example, the medical fraternity has been largely concerned with the health impact on patients, given the removal of long-standing treatments from the formular, private pharmacists with loss of business, and patients with rising costs, long queues and the unavailability of familiar drugs.
Ironically, in this debate, the most narrowly “technical” of all the submissions has been that of the Government itself, which has presented “the need to curb the rising cost of health care” as the beginning and end of its contribution.
It is on this basis that Comissiong was correct in isolating the Minister of Health’s slavish genuflection at the altar of neoliberal ideology as a key explanation for the shift in health policy. One of the distinctive features of the approach of the minister is his tendency to present “accounting” arguments where more humanistic, non-economic ones are required.
Thus, despite having responsibility for one of the most important arms of the social sector, his brain appears to be wired for profit and loss considerations.
The problem, however, is bigger than any personality who may or may not be occupying the office of Minister of Health. It points to a deeper crisis of the Caribbean independence project in which the state is slowly and steadily divesting itself of all social provision responsibilities. This is a direct reversal of what obtained at Independence, when, following centuries of colonial exploitation and social neglect, the new states took on social welfare as the legitimate, and in some cases, the most important, function of government.
Today, a new generation of Caribbean politician has emerged. He is unschooled in anti-colonial politics and force-fed on decades of neoliberal conditioning.
He rejects the view of the state as a defender of the poor and vulnerable, and is arrogantly proud of his uni-dimensional perspective.
The entire state machine is now being bent to the will of such neoliberals. C.Y. Thomas has remarked that whilst in an earlier period poverty reduction was the sine qua non of the Caribbean state, today this goal is now cast to a corner and left to “poverty reduction units”.
The crisis in health care provision, therefore, extends beyond the minister’s inherent neoliberalism. A critical moment has arrived. Neoliberalism will be reversed, but only following a decisive moment of mass social democratic resistance.
Tennyson Joseph is a political scientist at the University of the West Indies Cave Hill Campus specialising in analysis of regional affairs. Email [email protected]