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健康(关怀)宇宙中的重要因素:妄想、稀释和实现全民健康公正的途径。

What matters in health (care) universes: delusions, dilutions, and ways towards universal health justice.

机构信息

Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

College of Population Health, University of New Mexico, Albuquerque, USA.

出版信息

Global Health. 2019 Nov 28;15(Suppl 1):0. doi: 10.1186/s12992-019-0521-7.

Abstract

The presumed global consensus on achieving Universal Health Coverage (UHC) masks crucial issues regarding the principles and politics of what constitutes "universality" and what matters, past and present, in the struggle for health (care) justice. This article focuses on three dimensions of the problematic: 1) we unpack the rhetoric of UHC in terms of each of its three components: universal, health, and coverage; 2) paying special attention to Latin America, we revisit the neoliberal coup d'état against past and contemporary struggles for health justice, and we consider how the current neoliberal phase of capitalism has sought to arrest these struggles, co-opt their language, and narrow their vision; and 3) we re-imagine the contemporary challenges/dilemmas concerning health justice, transcending the false technocratic consensus around UHC and re-infusing the profoundly political nature of this struggle. In sum, as with the universe writ large, a range of matters matter: socio-political contexts at national and international levels, agenda-setting power, the battle over language, real policy effects, conceptual narratives, and people's struggles for justice.

摘要

实现全民健康覆盖(UHC)的全球共识假定掩盖了一些关键问题,这些问题涉及到构成“普遍性”的原则和政治,以及过去和现在在争取健康(保健)正义方面的重要问题。本文关注该问题的三个维度:1)我们根据 UHC 的三个组成部分,即全民、健康和覆盖,分别剖析 UHC 的言辞;2)特别关注拉丁美洲,我们重新审视了新自由主义对过去和当代争取健康正义的斗争的政变,并考虑了当前资本主义新自由主义阶段如何试图阻止这些斗争、利用其语言、并缩小其视野;3)我们重新构想了当代健康正义方面的挑战/困境,超越了围绕 UHC 的虚假技术官僚共识,并重新注入这场斗争的深刻政治性。总之,就像整个宇宙一样,许多问题都很重要:国家和国际层面的社会政治背景、议程设置权、语言之战、实际政策效果、概念叙事以及人们争取正义的斗争。

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