Policy without politics: the limits of social engineering. 2003

Vicente Navarro
Department of Health and Public Policy, Johns Hopkins University, Baltimore, Md 21205, USA. vnavarro@jhsph.edu

The extent of coverage provided by a country's health services is directly related to the level of development of that country's democratic process (and its power relations). The United States is the only developed country whose government does not guarantee access to health care for its citizens. It is also the developed country with the least representative and most insufficient democratic institutions, owing to the constitutional framework of the political system, the privatization of the electoral process, and the enormous power of corporate interests in both the media and the political process. As international experience shows, without a strong labor-based movement willing to be radical in its protests, a universal health care program will never be accepted by the US establishment.

UI MeSH Term Description Entries
D007750 Labor Unions Organizations comprising wage and salary workers in health-related fields for the purpose of improving their status and conditions. The concept includes labor union activities toward providing health services to members. Trade Unions,Labor Union,Trade Union,Union, Labor,Union, Trade,Unions, Labor,Unions, Trade
D009310 National Health Insurance, United States Federal system administering national health insurance in the United States. Federal Health Insurance Plans, United States,United States National Health Insurance
D011049 Social Control Policies Decisions for determining and guiding present and future objectives from among alternatives. Control Policies, Social,Control Policy, Social,Policies, Social Control,Policy, Social Control,Social Control Policy
D011057 Politics Activities concerned with governmental policies, functions, etc. Political Activity,Conservatism,Decentralization,Liberalism,Political Factors,Activities, Political,Activity, Political,Factor, Political,Factors, Political,Political Activities,Political Factor
D011209 Power, Psychological The exertion of a strong influence or control over others in a variety of settings--administrative, social, academic, etc. Power (Psychology),Power, Personal,Power, Professional,Power, Social,Power,Personal Power,Powers, Psychological,Professional Power,Psychological Power,Psychological Powers,Social Power
D011332 Privatization Process of shifting publicly controlled services and/or facilities to the private sector. Privatizations
D003709 Democracy A system of government in which there is free and equal participation by the people in the political decision-making process. Democracies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012922 Social Change A shift, alteration, modification, or evolution of human behavior and culture, which over time, results in measurable consequences on societal values and norms. Modernization,Social Development,Social Impact,Change, Social,Changes, Social,Development, Social,Developments, Social,Impact, Social,Impacts, Social,Social Changes,Social Developments,Social Impacts
D012923 Social Class A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. Caste,Social Gradients,Socioeconomic Level,Socioeconomic Status,Middle Class Population,Castes,Class, Social,Gradient, Social,Level, Socioeconomic,Middle Class Populations,Population, Middle Class,Social Classes,Social Gradient,Socioeconomic Levels,Status, Socioeconomic

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