Obamacare: The Neoliberal Model Comes Home to Roost in the United States - If We Let It

A dynamic, young, newly elected president makes health reform one of his highest priorities. His proposal aims to improve access for the uninsured and underinsured. To achieve that goal, he decides to collaborate with the private, for-profit insurance industry. Public hospitals and other public-sector institutions would compete with the private insurance sector for public, tax-generated revenues.
    The president in this case was César Gaviria Trujillo, President of Colombia, from 1990 to 1994. During 1994, health reform was enacted in Colombia by Law 100. The reform was mandated and partly financed by loans from the World Bank. Gaviria and colleagues presented the reform to financial elites at the World Economic Forum and elsewhere. The Colombian health reform became a model for health reform around the world and more recently in the United States.
    The Affordable Care Act (“Obamacare”) follows the neoliberal pattern favored by international financial institutions and multinational insurance corporations throughout the world. The ACA aims to enhance access by corporations to public sector health and social security/Medicare trust funds. An ideology favoring for-profit corporations in the marketplace justifies these reforms through unproven claims about the efficiency of the private sector and enhanced quality of care under principles of competition and business management. The ACA continues to deal with health care as a commodity to be bought and sold in a competitive marketplace, rather than as a fundamental human right to be guaranteed by government according to principles of social solidarity.