The creation of the health consumer

Challenges on health sector regulation after managed care era

Bibliographic Data

ID19534284
AuthorsCelia Iriart (0000-0002-2329-9629, Robert Wood Johnson Foundation, corresponding author), Túlio Batista Franco (0000-0001-7372-5262, Instituto de Saúde), Tulio Franco, Emerson Elias Merhy (0000-0001-7560-6240, Universidade Federal do Rio de Janeiro)
Year2011
Volume7
Issue1
Pages2
Publication date2011-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobalization and Health (JOURNAL)
Journal identifiersISSN: 1744-8603 • E-ISSN: 1744-8603
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/1744-8603-7-2
PMID21349181
PMCIDPMC3055814
OpenAlexW2156767781
LanguageEN
Citations received13
References cited15

BACKGROUND: We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. METHODS: We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. RESULTS: In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. CONCLUSIONS: We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply transformed the sector. Patients converted into consumers are exposed to the biomedicalization of their lives helped by the biopedagogies, which using subtle mechanisms present discourses as if they are objective and created to empower consumers. The analysis of judicialization of health policies in Brazil could help to understand the complexity of the problem and to develop democratic mechanisms to improve the regulation of the health sector

Business · Economic growth · Economics · Health care · Health care reform · Medicalization · Multinational corporation · Pharmaceutical industry · Political science · Public health · Public relations · Biomedical Ethics and Regulation · Medicine · Pharmaceutical Economics and Policy · Public Administration · Public Health in Brazil · Finance · Health Policy

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